Gundersen Tri-County Vendor Relationships
CMS MA-PD Requirements for Vendors
Gundersen Tri-County Hospital and Clinics values its relationships that have developed over the years with those serving as consultants, independent contractors, and suppliers of services and herein after referred to as "vendors". Because Gundersen Tri-County Hospital and Clinics contracts with insurance companies providing Centers for Medicare and Medicaid Services (CMS) approved Medicare Advantage – Prescription Drug (MA-PD) plan coverage for provider services to Medicare beneficiaries, we are required by CMS compliance program guidelines to provide certain compliance program information about CMS requirements that affect our vendors.
CMS has outlined MA-PD Compliance Program Guidelines applicable to vendors providing services to health care providers. These CMS guidelines are described in CMS' Medicare Managed Care Manual (Chapter 21) and Prescription Drug Benefit Manual (Chapter 9), and the related provisions for Medicare Advantage Organizations (MAO) and Medicare Prescription Drug Plans (PDP) (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423, collectively referred to as "Parts C & D."
Some of these CMS guidelines are:
- Screening of employees prior to hire and thereafter to ensure they are not excluded from participation in federal health care programs,
- A Code of Conduct
- Annual general compliance, and fraud, waste and abuse (FWA) trainings for your employees that meets Medicare standards
- Reporting to Gundersen Tri-County's Compliance Officer any suspected Medicare program violations including fraud, waste and abuse that affect Gundersen Tri-County's payments.
As a vendor to Gundersen Tri-County, please be aware of the Gundersen Tri-County's Standards of Conduct and its policies and procedures. Alternatively, a vendor may have their own Standards of Conduct, and comparable policies and procedures to meet CMS requirements.
Additional Gundersen Tri-County resources related to MA-PD:
CMS Training resources for MA-PD:
You will find links to the CMS Medicare Parts C and D General Compliance and Fraud Waste and Abuse trainings here: CMS Medicare Learning Network Compliance Program Trainings, Resources and FAQ
Conflicts of Interest
You may view our Conflicts of Interest policy below and its Disclosure Statement by clicking on the links below. If you have questions, concerns or would like to report a conflict of interest, please contact the Compliance Office for the Gundersen Regional Hospital Affiliates at (715) 538-1784.
We encourage you to share this Compliance Program information with your employees. Please feel free to contact the Compliance Officer for Gundersen Regional Hospital Affiliates at (715) 538-1784 to report any concerns or if you have any questions.