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).
As an effective means of communicating our compliance program requirements to our Participating Providers, we have facilitated the provider training by sharing our Code of Conduct and ensuring training of the CMS published Medicare Parts C and D Fraud, Waste and Abuse Training and Medicare Parts C and D General Compliance Training at https://learner.mlnlms.com/Default.aspx or via the PDF documents on this Provider Portal.
All Participating Providers will be required to provide copies of attestations corroborating completion of the compliance training program within 90 days of the effective date of the provider’s contract and annually thereafter. A copy of the Doctors HealthCare Plans, Inc. Attestation form is available for your use in PDF Format under the menu tab, “Downloadable Template Form”.
- Code of Business Conduct and Ethics
- CMS – Combating Medicare Parts C and D Fraud, Waste, and Abuse Web-Based Training Course- January 2018
- CMS – Medicare Parts C and D General Compliance Training Web-Based Training Course -January 2018
Last Updated: 10/15/2018