Fraud, Waste and Abuse Training for First Tier, Downstream and Related Entities  

Background  

The Centers for Medicare & Medicaid Services (CMS) has received numerous inquiries regarding the changes to 42 C.F.R § 422.503 (b) (4) (vi) and 42 C.F.R § 423.504 (b) (4) (vi) that became effective January 1, 2009. The regulation revision clarifies that Medicare Advantage Organizations (MAO) and Prescription Drug Plans (PDP) sponsors must apply FWA training to all entities they are partnering with to provide benefits or services in the Part C and Part D programs.  

In accordance with these CMS stipulations, Blue Cross Blue Shield of Georgia and its subsidiaries requires vendors and providers to train employees on Fraud, Waste and Abuse.  

FWA Training Options  

Many physicians and provider groups may use a training program developed internally, by their corporate headquarters or by their state’s medical association. If this includes your practice, you only need to complete the attestation form. You will need the Log on ID: BCBSGA and Password: fwatrain, to complete the online attestation. To access the attestation form Click here.  

Note: Only providers that have completed an internal Fraud, Waste and Abuse training or have taken FWA training through another entity or Medicare Advantage Organization should complete this attestation.  

If your practice does not have a training program, the National Health Care Antifraud Association (NHCAA), in conjunction with the Blue Cross and Blue Shield Association (BCBSA), has launched an online Fraud, Waste and Abuse General Compliance Training Course. This course was developed in collaboration with LearnSomething, Inc., a leading producer of customized, multimedia training and learning management solutions. This online training program was specifically developed to help Medicare Advantage first tier and downstream contractors meet CMS compliance requirements. You can access the online training via the course portal at www.wellpoint.learnsomething.com This course is reasonably priced, with volume discounts available and can be purchased through this link.  

Blue Cross Blue Shield of Georgia also offers a free Fraud, Waste and Abuse training. Our training meets CMS requirements and includes an attestation statement. Click here to access our free training.  

Important Dates  

Every provider and vendor that administers services to Medicare Advantage beneficiaries must complete a Fraud, Waste and Abuse training by December 31, 2009 and annually there after. You are only required to take training once a year to satisfy the CMS requirement for all insurers.  

Additional Information  

Please be sure to check our website and provider newsletters for updates to this CMS required Fraud, Waste and Abuse training.