Medicare Compliance Training: Protect Your Business & Patients

Medicare is the federal program that provides medical care insurance to those who are over 65 and retired or otherwise disabled and unable to work. This very complicated program has a high potential for fraud and abuse.

Employee Training

• Those involved in selling the Medicare program to seniors and administering it must go through an employer-developed compliance program to show that they understand their obligations under the law. Each employee must sign a certification that he received the training. New employees should attend the compliance classes as soon as possible. Annual refresher classes emphasize the statutory, regulatory and contractual requirements, as well as the company's code of conduct.

Types

• Medicare compliance training can take place in a group setting such as a classroom. For independent insurance agents, training often entails self-paced Internet instruction to fit their schedules. There is no legal requirement for a certain style of training.

Features

• Some companies use actual case scenarios with the identities carefully deleted. This provides a "real world" look at problems and solutions. Covered issues include Medicare marketing, sales techniques and ethical concerns such as signing a family to a program they cannot afford.

Considerations

• Medical treatment facilities have their own need for a compliance program to ensure the integrity of the Medicare program, but as of 2010, there is no federal mandate for facilities to present such a program to their employees.