Provider Compliance Program Guidelines:
Doctors HealthCare Plans, Inc. has adopted and implemented a compliance program that includes measures to prevent, detect and correct noncompliance with the Centers for Medicare and Medicaid Services (CMS) provisions for Medicare Advantage Organizations (MAO) and Medicare Prescription Drug Plans (PDP) as set forth in 42 CFR §§ (b)(4)(vi) and 423.504(b)(4)(vi). Providers are required to comply with CMS outlined compliance program requirements upon initial contract and as necessary thereafter.
Providers must maintain a compliance program, policies and procedures, standards of conduct, general compliance and FWA training. Records of material distribution and training must be maintained for 10 years. Doctors HealthCare Plans or CMS, may request documentation to verify compliance. If you do not have a Compliance Program in place, please work with your Provider Relations Representative.
Below is our Code of Conduct and Compliance Training for your reference and review. Review of these documents is required of healthcare providers and those supporting their contracts with Doctors HealthCare Plans, Inc. It is critical that sufficient awareness is gained of the compliance requirements.
Last Updated: 06/07/2021