Medicare Advantage-Prescription Drug Fraud, Waste, and Abuse Training

The Centers for Medicare & Medicaid Services (CMS) requires all Medicare Advantage - Prescription Drug health plans to ensure that their participating providers complete Fraud, Waste, and Abuse training annually1. In order to assist its member health plans in complying with this requirement, HealthCare Administrative Solutions (HCAS) has created this website, which includes an online training program to be completed by providers.

NOTE: In the Final Rule published in the Federal Register on April 15, 2010, CMS clarified that providers “who have met the fraud, waste, and abuse certification requirements through enrollment into the Medicare program or accreditation as a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) are deemed to have met the training and educational requirements for fraud, waste, and abuse."

This online training program is the most up to date CMS Medicare part C and D Fraud, Waste and Abuse training, please do the following:

  1. Click on the first link below (Step 1) to take the training
  2. Click on the second link below (Step 2) and attest that you have completed training

     TRAINING – View the CMS presentation

(Note: If you have fulfilled training requirements at another location, proceed to Step 2 – Attestation- where you may indicate the location at which you have completed required training)

     ATTESTATION Attest that you have completed training - Required


For additional information click on the following links:

For questions or assistance with this process please contact any of the health plans below.

Blue Cross Blue Shield of Massachusetts

Network Management and Credentialing Services
1-800-316-BLUE (2583).
networkmanagement@bcbsma.com
Fraud Hotline: 1-800-992-4100

Fallon Health

Provider Relations Line
1-866-275-3247 prompt 4
AskFCHP@fallonhealth.org
Compliance Hotline: 1-888-203-5295


BCBSMA Dental Provider Contact

Dental Network Management
1-800-882-1178 Option 4
DentalProviderRequests@bcbsma.com
Fraud Hotline: 1-800-992-4100


Harvard Pilgrim Health Care

Provider Service Center
Telephone: 1-800-708-4414
provider_callcenter@point32health.org
Point32Health Compliance and FWA
Hotline: 877-824-7123

Tufts Health Plan

Medicare Preferred Provider Svs
888-880-8699 Ext. 52169
THPMP_provider_relations@point32health.org
Anonymous Fraud Reporting:1-877-824-7123




Health New England

Provider Relations Department
1-800-842-4464 ext. 5000
providerrelations@hne.com
FWA/Reporting:
http://HealthNewEngland.org/Fraud-Waste-Abuse-Prevention-Program
Fraud Hotline: 1-800-453-3959

WellSense Health Plan

Provider Relations
Call: 888-566-0008
Provider.info2@Wellsense.org
Fraud Hotline: 888-411-4959

[1] See 42 CFR 422.503, 422.504, 423.504, 423.505 et seq.; see also Centers for Medicare and Medicaid Services, Prescription Drug Benefit Manual, Chapter 9 – Part D Program to Control Fraud, Waste and Abuse.


 
 

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