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Medicare

Information and resources for health care providers.

Important: Annual Medicare Compliance Program Requirements



Each year, all contracted providers participating in our Medicare Advantage (MA), Prescription Drug Plans (MAPD & PDP), Medicare-Medicaid (MMPs) and/or Dual Special Needs Plans (DSNPs) are required to attest to meeting the Centers for Medicare & Medicaid Services (CMS) compliance program requirements for first-tier, downstream and related (FDR) entities and if contracted for DSNP, the MOC training.

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Need more information on the Medicare Compliance requirements?

FDR and DSNP MOC Training Information:

Medicare compliance FDR program guide (PDF)

FDR frequently asked questions (PDF)

DSNP Model of Care (MOC) (PDF)

 

Read our Office Manual and/or Newsletters to learn more on Medicare program requirements:

Office Manual (PDF)

FDR Compliance Newsletters

OfficeLink Newsletters

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2021 Medicare Compliance FDR or FDR/DSNP Attestations:

The 2021 Medicare Compliance FDR Attestations will open in 2nd or 3rd quarter of 2021.  The attestation links will be posted on this site when released.

Have questions on the Medicare Compliance or DSNP Programs? Email us at FDRAttestation@AETNA.com

Join our Medicare Advantage Quality Incentive Program

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Join our Medicare Advantage Quality Incentive Program

This program includes ways to promote early detection and assessment of chronic conditions. You'll provide the care your patients need, while earning incentives. You can participate if you are a primary care physician with 50 to 749 attributed Aetna Medicare Advantage members and are not participating in another Aetna/Coventry value-based contract or program.

Part D prescriber enrollment requirement

Part D prescriber enrollment requirement

Any health care professional who prescribes drugs to patients with Part D plans must now enroll in the Medicare program or opt out. If you do not enroll or opt out, Medicare Part D may no longer cover these drugs as of February 1, 2017. Please try to enroll or opt out by November 1, 2016. This will allow time for application processing and ensure that patients get their prescriptions without disruption.

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For non-participating Aetna Medicare PPO providers

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For non-participating Aetna Medicare PPO providers

We are expecting an increase in membership for our Medicare Advantage preferred provider organizations. You are likely to see more patients with these health plans.

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.