Providers that contract with Blue Cross to provide health, prescription or administrative services to Medicare enrollees must meet the Centers for Medicare & Medicaid Services (CMS) education and training requirements related to fraud, waste and abuse. Effective January 1, 2011, CMS changed the requirements so that most providers will not need to demonstrate to Blue Cross that they have met these requirements.
You are not required to take the Blue Cross Medicare Fraud, Waste and Abuse training if:
If you do not meet the above, you are required to take the training offered by Blue Cross or another Medicare Advantage Organization or Part D Plan Sponsor. The training and accompanying attestation form must be completed annually.
View the product guide (PDF) for a complete list of products for Medicare beneficiaries.
Recent public policy developments have resulted in the most significant changes to Medicare in 30 years. Many health plans are either broadening their Medicare product options or offering Medicare products for the first time. Some of the recent developments are:
Blue Cross has been offering Medicare products for more than 20 years. We have expanded our offerings to meet the changing needs of seniors. We are also simplifying claims administration for providers:
Providers are required to report any potential Medicare Secondary Payer information to Medicare. Blue Cross does not require the fulfillment of CMS' MSP information. Under Medicare Advantage Plans, enrollees turn over their Medicare Part A and Medicare Part B to Blue Cross when they become enrolled in one of our Medicare plans, such as MedicareBlue PPO or SecureBlue. For Blue Cross members that have selected our VantageBlue product, the MSP would not be required for the Medicare Part B services, but would be required for the Part A services that are processed by Medicare (Noridian). However, Blue Cross will inquire with the subscriber about secondary payer information at least once a year as it does currently today for its other Blue Cross products. Learn more about MSP (PDF).