Medicare Advantage Plans

In 2017, BlueCross will offer prescription drug plans BlueCross Rx ValueSM and BlueCross Rx PlusSM.   

General Information

Medicare Advantage (MA) Preferred Provider Organization (PPO) Network Sharing  - This document describes how MA PPO members can get in-network benefits when traveling or living in another Plan's service area.             

Fraud and Compliance Awareness

The Centers for Medicare & Medicaid Services (CMS) developed two training modules for (1) compliance and (2) fraud, waste and abuse (FWA).  These training modules are for use by health plans and the entities they partner (contract) with to provide services. This was done to reduce the burden on providers being asked to complete and attest to multiple compliance and FWA trainings from several insurers. 

Our providers who participate in the BlueCross MA network can fulfill this training requirement by choosing one of these methods:

All MA and PDP plans must accept certificates of completion of this CMS Compliance and FWA training (located on the Medicare Learning Network) from network providers. BlueCross still requires attestation for our MA and PDP plans from contracted network providers in 2017. You must complete the CMS FWA and compliance training and submission of the attestation by April 1st annually.

BlueCross acknowledges that some MA providers may have complete an internal CMS-approval compliance training course with their staff. In this case, you will only need to submit our BlueCross MA Attestation Form. This assures our health plan that you have met the annual compliance requirement.

Compliance Training Attestation

After you complete the compliance training, a certificate of completion will generate. You should print and retain this certification to validate that annual training has occurred for all staff. You will also need to complete BlueCross' compliance attestation or submit a copy of the CMS compliance certificate to us by emailing provider.education@bcbssc.com or by faxing to 803-264-8223.