Clarification Regarding Fraud, Waste, and Abuse Training Requirements

RCPA’s Human Resources Committee met this week, and there was discussion regarding provider responsibilities for trainings for their employees and resources available to provide the needed training. We want to clarify that these requirements apply to providers of Medicare services, not Medicaid.

CMS offers an online resource – Medicare Learning Network (MLN) as a free resource to the public. One area covered in the MLN is Medicare Parts C and D Compliance and Fraud, Waste, and Abuse (FWA) Trainings. Prior to January 1, 2019, CMS required providers of Medicare services to utilize their training to meet this requirement. Beginning January 1, 2019, CMS no longer requires health care providers participating in Medicare Advantage and Part D plans to complete CMS issued training, in order to allow the training to be offered in a manner that is tailored to each organization’s operations and risks.

Providers of Medicaid Services (Waiver services are funded through Medicaid) are not mandated to provide FWA training to their employees. Although this is not a mandated training, providers may offer this training as a part of your compliance training for all staff.

For more information regarding these training requirements, please refer to the CMS website and the Compliance Program Frequently Asked Questions document. If you have any further questions, please contact Carol Ferenz.