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News

The Centers for Medicare & Medicaid Services (CMS) requires that providers complete training related to Medicare fraud, waste and abuse (FWA) on an annual basis.

Have you taken a course yet? Visit www.AetnaEducation.com and select the “Medicare Advantage Plans” course catalog to access.

If you already completed FWA training offered by another Medicare Advantage organization or Part D Plan Sponsor, you do not need to complete the Aetna FWA training or provide a completion attestation, which may have been required by other organizations. We will audit to confirm your compliance with this CMS requirement. As part of the audit process, we may ask that you provide evidence that FWA training materials were provided and FWA training was completed.

 

Medical

Pharmacy 

  • Aetna Pharmacy Management (APM) only uses National Provider Identifiers (NPI) to identify pharmacies during HIPAA standard online transactions. As of March 28, 2009, APM no longer accepts these transactions without an NPI.

Dental

On August 15, 2009, Aetna's policies on Serious Reportable Events and Never Events took effect. You can view the policies on the secure provider website via NaviNet. Log in and:

  • Select "Aetna Health Plan" from the Plan Central home page.
  • Select "Claims" on the left-hand menu, then "Policy Information (Step 3)" and scroll down to select "Claim Payment and Coding Policies."
  • Search by "N" for "Never Events and Serious Reportable Events" (facility policy), or by "P" for "Professional Fees for 'Never Events'" (professional policy).