Fraud, Waste and Abuse or FWA

policy doctor

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Well here we go again!! The drones at CMS dreamed up another module for us MA brokers to take. It's called the fraud, waste and abuse training.

I'm trying not to 'cuss but WTF! Isn't that supposed to be their job?

By now i'm sure you're getting your alerts from various companies.



Dear Valued Partner:
[FONT='Arial Narrow','sans-serif']The Centers for Medicare & Medicaid Services (CMS) mandated a new fraud, waste, and abuse training requirement. This mandate may be found in the Federal Register, Vol. 72, No. 233 (December 5, 2007) and requires that Medicare Advantage Organizations and Part D Plan Sponsors provide brokers and agents with Fraud Waste and Abuse (FWA) training. This training must be completed by December 31, 2009 and annually thereafter. Participation in this training is mandatory for brokers and agents contracted to sell Medicare Advantage (MA and MA-PD) plans and Medicare Prescription Drug plans (PDPs).[/FONT]
 
I just had a client call me, the MAPD plan that I wrote him is having a 300% rate increase. One of the things it said is to call Medicare for info on different plans that are available. My client called medicare and Medicare told him about this particular company that was only 70 a month. $0 copays on doctors, 25 copay for inpatient hospitalization, etc. sounded like a great plan. She gave him the phone # for the company and told him to call the company. He calls me instead and asked if I knew anything about this company, I went to Medicare's website and looked at it, sure enough it had all of the great features she mentioned, only problem he had to be in a nursing home or assisted living facility to get it, it was a SNF plan. Lets hope those secret shoppers are calling Medicare also, if they're not they should be.
 
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