The following provider training modules must be completed annually by healthcare providers who participate with Humana Medicare Advantage, Humana Medicaid or Humana Medicare-Medicaid dual plans.
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Fraud, Waste and Abuse (FWA) – FWA training is still required. However, effective Jan. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) dropped its requirement that sponsors, such as Humana, confirm contracted providers’ adherence to CMS-issued general compliance and FWA training by collecting an attestation from them. However, under their CMS contracts, plan sponsors remain obligated to conduct oversight, which can include routine monitoring and/or auditing. Humana reserves the right to request evidence, at any time, that compliance and FWA training are occurring and tracked, and that the contractor has processes in place to ensure adherence.
Please refer to the Frequently Asked Questions and Answers document below for additional guidance on this requirement.
For providers serving Humana special needs plans (SNP) training
Only providers serving patients with Humana Medicare preferred provider organization (PPO) and health maintenance organization (HMO) plans in certain states and territories must take special needs plans (SNP) training.
Humana-participating healthcare providers serving Humana Medicare PPO members in these states are required to take SNP training:
- Missouri
- New York
- North Carolina