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Medicare resources for providers

We’re here to help you stay compliant with Medicare regulations. Find information about Aetna Medicare Advantage plans, compliance and attestation requirements, training and more.

Aetna Medicare Advantage plans include any of the following:

 

Aetna Medicare Advantage (MA) plans include HMO, PPO and SNP (Special Needs Plans) benefits to Medicare-qualified members. Aetna offers Dual Special Needs Plans (D-SNPs) to members who also receive Medicaid benefits and/or assistance with Medicare premiums or Parts A & B cost-sharing and live in a county where Aetna Medicare offers a D-SNP. D-SNPs include any of the following:

 

  • Dual Eligible Special Needs Plans (D-SNPs)
  • Highly Integrated Dual Special Needs Plans (HIDE-SNPs)
  • Fully Integrated Special Needs Plans (FIDE-SNPs)

The Aetna Medicare-Medicaid (MMP) is not a Medicare Advantage plan. The MMP is a plan that provides coordinated Medicare and Medicaid benefits for dually eligible individuals.

 

Aetna Medicare Advantage quick reference guide (PDF)

 

Annual Medicare compliance program requirements

Annual Medicare compliance program requirements

Every year, all providers who participate in our MA plans are required to meet the Centers for Medicare & Medicaid Services (CMS) compliance program requirements for first-tier, downstream and related entities (FDR).

 

Keep in mind: We complete yearly random audits to help make sure you’re compliant.

 

Required compliance and training

 

Review Aetna FDR Medicare compliance guide (PDF)

For all Medicare providers/delegates, for all plan types.

 

Review SNP Model of Care/MOC training (PDF)

For all providers/delegates treating SNP members.

 

Questions about compliance requirements? We’ve got answers. Check out our frequently asked questions (PDF).

Annual Medicare compliance attestation

 

Once you’ve reviewed the required compliance and training, you can complete your yearly attestation. Keep in mind that attestations need to be signed electronically. Unfortunately, we can’t accept paper, downloaded, faxed or mailed attestations. Need help? This guide can help you with the next steps.

 

Update: 2023 Annual Medicare compliance attestation closed on January 31, 2024. If you complete your attestation after that date, it will count for 2024.

 

Medicare plan(s)

Attestation requirements

MA only

MA and MMP plans

Attestation is required. Complete your attestation by October 31.

 

Complete MA only MA and MMP attestation (PDF)

MA and SNP plans

Attestation is required. Complete your training and attestation by October 31. 

 

Complete MA and D-SNP attestation (PDF)

Delegated entities:

MA only

MMP only

MA and MMP

Attestation is required for first-tier entities. Complete your training and attestation by October 31. 

 

Complete MA/MMP attestation for first-tier entities (PDF)

Delegated entities:

MA and SNP

Attestation is required for first-tier entities. Complete your training and attestation by October 31. 

 

Complete MA and/or SNP attestation (PDF)

Medicare plan(s)

MA only

MA and MMP plans

Attestation requirements

Attestation is required. Complete your attestation by October 31.

 

Complete MA only MA and MMP attestation (PDF)

Medicare plan(s)

MA and SNP plans

Attestation requirements

Attestation is required. Complete your training and attestation by October 31. 

 

Complete MA and D-SNP attestation (PDF)

Medicare plan(s)

Delegated entities:

MA only

MMP only

MA and MMP

Attestation requirements

Attestation is required for first-tier entities. Complete your training and attestation by October 31. 

 

Complete MA/MMP attestation for first-tier entities (PDF)

Medicare plan(s)

Delegated entities:

MA and SNP

Attestation requirements

Attestation is required for first-tier entities. Complete your training and attestation by October 31. 

 

Complete MA and/or SNP attestation (PDF)

Be on the lookout for Medicare compliance updates

Be on the lookout for Medicare compliance updates

We’ll keep you informed about annual compliance requirements through Adobe Acrobat Sign email or postcard. You can also check out our OfficeLink Updates™ for news throughout the year.

 

Browse OfficeLink Updates library

 

Additional resources 

 

Provider office manual (PDF)

 

FDR compliance newsletters

 

Offshore information (PDF)

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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