CMS outlines requirements specific to contracted third parties supporting Medicare in Chapter 9 and Chapter 21
The intent of both CMS and Humana’s Compliance Program is to minimize violations, additional costs and risks pertaining to Medicare; especially adverse impacts to Medicare beneficiaries. Humana has distilled the information from the above manual and multiple Government resources into the following policies:
- Ethics Every Day for Contracted Healthcare Providers and Third Parties (Standards of Conduct)
pdf opens in new window - Compliance Policy for Contracted Healthcare Providers and Third Parties
pdf opens in new window
These documents include what’s required to ensure an effective compliance program to prevent, detect and correct noncompliance, fraud, waste and abuse.
Each FDR of Humana must:
- Comply with what’s outlined within the policies
- Provide the documents or materially-similar policies upon hire/contract and annually thereafter to all employees and third parties designated to render a service or perform a function in support of Humana’s Medicare products.
Notable topics within the policies
Requirements and Time Frames, as applicable, for Organizations and Individuals
- Having Written Policies
- Reporting Concerns of Violations
- Conducting or Assuring Compliance Education and Related Training
- Examples of Violations and Possible Consequences
- Oversight Activities to Conduct
- Reporting Offshore Arrangements
- Retention of Documentation and Materials
For additional guidance, see our Humana 2026 FDR Compliance Program FAQs
What if I have a question that’s not addressed in the FAQ above?
Direct a request for guidance about these requirements to Humana FDR Compliance at ThirdPartyFDRCompliance@humana.com .
Note: There are other, segment-specific pages that may apply to your organization. They’re listed below and the first two include their own FAQs. As necessary, access the corresponding page(s) before reaching out to the team above: