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Don’t Overlook FDR Compliance

Compliance Basics
in Compliance Basics
By Team KMCU

Have you received an Attestation request?

Lately we have received several inquiries regarding Attestation requests from contracted Medicare Advantage Plans. Some doctors are receiving them because they recently credentialed with the plan, others because this is a yearly requirement and the year is almost over. If you recently credentialed with a Medicare Advantage plan, you are usually required to attest to your FDR compliance status within 90 days of joining a network. If you are a network provider, you are required to attest yearly.

What is FDR?

FDR is a CMS acronym for First tier, Downstream, or Related entity. A First Tier Entity is any party that enters into a written arrangement (acceptable to CMS) with a Medicare Advantage (MA) organization to provide administrative or health care services to a Medicare-eligible individual in the MA program. Most chiropractic providers fall into this category.

If you have received a request to attest DO NOT ignore it... it could impact your provider status with the payer. Most notices provide payer portal information or a link to Availity so you can complete the necessary information. We encourage you to locate the Fraud, Waste, and Abuse and General Compliance Training (as it is often referred to) or the FDR Compliance Training on the payer portal site and follow all of the instructions. If you find that you have not completed the compliance steps, take immediate action to complete and implement them before the end of the year. This will ensure you meet the attestation deadline.

Most of the compliance-related standards are already a part of OIG and HIPAA Compliance except for the specialized Fraud, Waste, and Abuse (FWA) training by CMS. If you find your practice needs assistance with anything compliance related, reach out to KMC University for expert advice and assistance. 

Library Members can find a helpful fact sheet titled “What is FDR?” that contains links to major payer websites for easy access to FDR resources in Medicare Classroom 5 Medicare Billing Lesson 3, titled Medicare Advantage Plans.

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