FLASH: Assistant Surgeon Reimbursement Rate Change

Assistant Surgeon Reimbursement Rate Change

Effective January 1, 2016, Health Alliance is changing the reimbursement for assistant surgeons from 25% to 20% to align with CMS standards. If you have any questions about this change, please contact your provider relations specialist.

New CMS Training Requirements

Starting in 2016, all Medicare Advantage organizations and Prescription Drug Plan sponsors, like Health Alliance Medicare, will be required to provide general compliance and fraud, waste, and abuse (FWA) training for all employees of their organization and for the first-tier, downstream, and related entities (FDRs) they partner or contract with to provide benefits or services.

If you have a contractual relationship with Health Alliance Medicare, you are considered an FDR, and you and all your employees are required to complete this training.

Please ensure that you and your employees complete the general compliance and/or FWA training modules located on the Centers for Medicare & Medicaid Service’s (CMS) Medicare Learning Network (MLN). Choose “Web-Based Training Courses” under “Related Links” to get to the training modules. The MLN system-generated certificates of completion will serve as evidence of compliance.

As an FDR, you must maintain certificates or documentation of training completion (certificates of completion, training logs, system-generated reports, spreadsheets, etc.), containing at least employee names, dates of employment, dates of completion, and passing scores (if captured), for 10 years.