Provider Compliance Training Materials
- Compliance Policy for Contracted Health Care Providers and Business Partners
- Ethics Every Day for Contracted Health Care Providers and Business Partners (Standards of Conduct)
- General Compliance training and Fraud, Waste and Abuse (FWA) training (via CMS-published content)
- Special Needs Plans (SNP) training (if the contracted party has one or more practitioners participating in any Humana Medicare HMO network in one of the following states or territories: Alabama, California, Colorado, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Mississippi, Missouri, Mississippi, Montana, North Carolina, Nebraska, Nevada, New York, North Carolina, Ohio, Pennsylvania, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, or Washington)
- Medicaid-specific trainings (if the contracted party is supporting the Humana Florida Medicaid Plan [identified on member ID cards as Humana Comprehensive Plan, Humana Long-Term Care Plan and/or Humana Medical Plan] or Humana Gold Plus Integrated [Medicare-Medicaid Plan] in Illinois), its training may include any or all of the following, depending on the state: Florida or Illinois Humana Orientation Training; Medicaid Provider Training; Health, Safety and Welfare Training; and Cultural Competency Training)
Humana recognizes that practitioners enrolled in the Medicare program or accredited as a durable medical equipment, prosthetics, orthotics and supplies (DME POS) provider are deemed to have met the FWA training and education requirements. In this situation, a contracted party’s representative will have an opportunity to record how it meets the FWA training requirement and affirm its use of the CMS content for general compliance training of its employees, and, if applicable, non-employees contracted as individuals or working for a sub-contracted entity that supports a Humana contract.
However, deemed practitioners are still responsible for adhering to the requirements outlined in the compliance policy, business ethics, general compliance training and (if applicable) Medicaid and SNP components of the training. Therefore, a contracted party with one or more deemed practitioners must attest to compliance with these above-listed trainings. More information is available in the frequently asked questions and answers document located here.