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General Compliance and Fraud, Waste, Abuse (FWA)

Please use the links below for reference material

It is the responsibility of the network pharmacy provider to remain compliant and ensure all staff are trained on applicable laws, rules, regulations and regulatory guidance.  Training includes but is not limited to Anti-FWA, Code of Conduct (general compliance), Cultural Competency (CAMA), Abuse, Neglect and Exploitation (ANE).

Resources to distribute

Abuse, Neglect & Exploitation (ANE)

Access ANE training materials.

Cultural Competency Training

Access cultural competency training materials.

"Your Rights" forms for enrollees

Access "Your Rights" forms for enrollees.

Optum Rx code of conduct policies

CMS requires  Network Pharmacy Providers to provide access to the Optum Rx code of conduct policies to staff. CMS does not require adoption of these policies.

Reporting a FWA Incident

Report suspected or potential FWA incidents.