April 2017 monitoring
During the course of 2017, the Sales Compliance team at Wellmark will monitor a random sample of agents for compliance with these requirements. April, Wellmark will monitor a random sample of agent FDRs for:
*Provide information to the agent FDR's employees and downstream and related entities about how to report potential compliance issues or fraud, waste or abuse (FWA) to Wellmark and/or RAS as well as have a non-retaliation policy for those that make a valid report.
What is required?
Each agent FDRs must provide their employees and downstream and related entities with information about how to report FWA and other non-compliance to Wellmark and/or to the Northern Plains Alliance (NPA).
What are the reporting options?
Reports can be made to NPA's hotline (1-866-311-4216), and these reports can be made anonymously. Additionally, reports may also be made directly to the Wellmark Compliance Office (515-376-4949) or firstname.lastname@example.org.
What resources are provided?
View a sample poster that can be displayed or communicated by agent FDRs to their employees. More information on his poster and Medicare Compliance can be found on the Medicare Compliance (you will be required to login before viewing the link) resource page in the Producer Connection portal located on Wellmark.com.
How will Wellmark monitor?
Wellmark will monitor a random sample of agent FDRs in April and request evidence that mechanisms for reporting non-compliance and FWA have been provided to employees. Evidence that exhibits compliance with this requirement include providing a poster or communication to employees with reporting information, including reporting information in policy manuals or training materials, and internet links. Agent FDRs selected for monitoring will be contacted by an email from Wellmark Sales Compliance.
IT IS IMPORTANT THAT IF YOU GET AN EMAIL FROM THE SALES COMPLIANCE DEPARTMENT DURING THIS AUDIT PROCESS THAT YOU RESPOND.