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Medicare compliance and attestation

We’re here to help health care providers stay compliant with Medicare regulations. Find helpful info about compliance training, attestation requirements and more.

 

If you participate in Aetna® Medicare Advantage (MA) plans, you need to complete yearly attestation.

 

MA plans include:

HMO, PPO and Special Needs Plan (SNP) benefits

 

SNPs include:

  • Dual Eligible Special Needs Plans (D-SNPs)
  • Highly Integrated Dual Special Needs Plans (HIDE-SNPs)
  • Fully Integrated Special Needs Plans (FIDE-SNPs)
  • Institutional Special Need Plans (I-SNPs)
  • Chronic Special Needs Plans (C-SNPs)

The Aetna Medicare-Medicaid plan (MMP) isn’t a Medicare Advantage plan. The MMP provides coordinated benefits for people who are eligible for both Medicare and Medicaid.

Annual Medicare compliance program requirements

 

All providers who participate in our Medicare Advantage plans need to meet the Centers for Medicare & Medicaid Services (CMS) compliance program requirements for first-tier, downstream and related entities (FDR). We do random audits to help make sure you’re compliant.

 

Step 1: Complete training

 

For all Medicare providers/delegates, for all plan types: Review Aetna FDR Medicare compliance guide (PDF).

 

For all providers/delegates treating SNP members: Review SNP Model of Care/MOC training (PDF).

 

Step 2: Complete attestation by October 31

 

After you’ve reviewed the required compliance and training, complete your attestation. You need to do this every year. You’ll get credit for the year in which you complete it.

 

Important: We can’t accept paper, downloaded, faxed or mailed attestations. To get credit, e-sign the attestation using one of these links:

 

Medicare plan(s)

Attestation requirements

MA and/or MMP plans

MA and SNP plans

Delegated entities: MA and/or MMP plans

Delegated entities: MA and SNP

Medicare plan(s)

MA and/or MMP plans

Attestation requirements

Medicare plan(s)

MA and SNP plans

Attestation requirements

Medicare plan(s)

Delegated entities: MA and/or MMP plans

Attestation requirements

Medicare plan(s)

Delegated entities: MA and SNP

Attestation requirements

 

Questions about compliance training or attestation? Find answers.

 

Frequently asked questions (PDF)

Looking for updates?

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

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