Last Call: All Providers Must Complete 2015 Compliance Training and Certification
Dec. 31, 2015, marks the last day that Humana-contracted health care providers can complete compliance requirements mandated by the Centers for Medicare & Medicaid Services (CMS). Health care providers are expected to review and provide certification regarding the following 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 and Fraud, Waste and Abuse (FWA) training
- Special Needs Plans (SNP) training (if the organization has physicians or other practitioners participating in any Humana Medicare HMO network in one of the following states or territories: Alabama, Arkansas, Arizona, California, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Missouri, Mississippi, North Carolina, Nevada, New York, Ohio, Puerto Rico, South Carolina, Tennessee, Texas, Virginia or Washington)
- Medicaid-specific trainings (if the physician’s or practitioner’s organization is supporting a Humana-Medicaid plan): Humana Orientation Training; Medicaid Provider Training; Health, Safety and Welfare Training; and Cultural Competency Training
Health care providers can complete this information online via Humana's secure compliance website. To access the website, health care providers must be registered on Humana.com/providers or Availity.com. Detailed instructions and additional information on completing these requirements, including registration, are available here.
- The review and confirmation (via attestation form) of these materials help meet health care providers’ contractual obligation to comply with state and federal law and Humana's policies and procedures.
- This attestation requirement is intended to be completed at the contract level. That is, if every practitioner in an organization has a direct contract with Humana, then each practitioner must complete the required attestation. However, if a practitioner is contracted with Humana through a group contract, then each practitioner must complete the training and coordinate within the organization to have the person responsible for compliance complete the required attestation.
- Please note that if an organization provides multiple functions for Humana, its compliance contact may receive an additional notification from Humana. The organization only needs to complete this requirement once.
- More information is available in the frequently asked questions and answers document located here.
Questions about these requirements may be directed to Humana Provider Relations at 1-800-626-2741.
If a physician or practitioner suspects or becomes aware of potential noncompliance and/or fraud, waste and abuse, he or she may report it immediately utilizing the Ethics Help Line at 1-877-5 THE KEY (1-877-584-3539) or the Ethics Help Line online reporting site at https://www.ethicshelpline.com.