Medicare plan(s)
Medicare resources for providers
We’re here to help you stay compliant with Medicare regulations. Find information about Aetna Medicare Advantage plans, compliance and attestation requirements, training and more.
Aetna Medicare Advantage plans include any of the following:
Aetna Medicare Advantage (MA) plans include HMO, PPO and SNP (Special Needs Plans) benefits to Medicare-qualified members. Aetna offers Dual Special Needs Plans (D-SNPs) to members who also receive Medicaid benefits and/or assistance with Medicare premiums or Parts A & B cost-sharing and live in a county where Aetna Medicare offers a D-SNP. D-SNPs include any of the following:
- Dual Eligible Special Needs Plans (D-SNPs)
- Highly Integrated Dual Special Needs Plans (HIDE-SNPs)
- Fully Integrated Special Needs Plans (FIDE-SNPs)
The Aetna Medicare-Medicaid (MMP) is not a Medicare Advantage plan. The MMP is a plan that provides coordinated Medicare and Medicaid benefits for dually eligible individuals.
Aetna Medicare Advantage quick reference guide (PDF)
Annual Medicare compliance program requirements
Annual Medicare compliance program requirements
Every year, all providers who participate in our MA plans are required to meet the Centers for Medicare & Medicaid Services (CMS) compliance program requirements for first-tier, downstream and related entities (FDR).
Keep in mind: We complete yearly random audits to help make sure you’re compliant.
Required compliance and training
Review Aetna FDR Medicare compliance guide (PDF)
For all Medicare providers/delegates, for all plan types.
Review SNP Model of Care/MOC training (PDF)
For all providers/delegates treating SNP members.
Questions about compliance requirements? We’ve got answers. Check out our frequently asked questions (PDF).
Annual Medicare compliance attestation
Once you’ve reviewed the required compliance and training, you can complete your yearly attestation. Keep in mind that attestations need to be signed electronically. Unfortunately, we can’t accept paper, downloaded, faxed or mailed attestations. Need help? This guide can help you with the next steps.
Update: 2023 Annual Medicare compliance attestation closed on January 31, 2024. If you complete your attestation after that date, it will count for 2024.
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Attestation requirements |
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MA only MA and MMP plans |
Attestation is required. Complete your attestation by October 31.
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MA and SNP plans |
Attestation is required. Complete your training and attestation by October 31.
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Delegated entities: MA only MMP only MA and MMP |
Attestation is required for first-tier entities. Complete your training and attestation by October 31.
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Delegated entities: MA and SNP |
Attestation is required for first-tier entities. Complete your training and attestation by October 31.
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Medicare plan(s) |
MA only MA and MMP plans |
|---|---|
Attestation requirements |
Attestation is required. Complete your attestation by October 31.
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Medicare plan(s) |
MA and SNP plans |
Attestation requirements |
Attestation is required. Complete your training and attestation by October 31.
|
Medicare plan(s) |
Delegated entities: MA only MMP only MA and MMP |
Attestation requirements |
Attestation is required for first-tier entities. Complete your training and attestation by October 31.
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Medicare plan(s) |
Delegated entities: MA and SNP |
Attestation requirements |
Attestation is required for first-tier entities. Complete your training and attestation by October 31.
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Be on the lookout for Medicare compliance updates
Be on the lookout for Medicare compliance updates
We’ll keep you informed about annual compliance requirements through Adobe Acrobat Sign email or postcard. You can also check out our OfficeLink Updates™ for news throughout the year.
Browse OfficeLink Updates library
Additional resources
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Health benefits and health insurance plans contain exclusions and limitations.