Regence contracts with the Centers for Medicare & Medicaid Services (CMS) to provide Medicare Advantage and Prescription Drug Plans that provide health care and prescription drug benefits to Medicare beneficiaries. As a part of these contracts, CMS requires us to oversee our healthcare providers, vendors, and other organizations that assist us in providing services for our Medicare beneficiaries. In addition to healthcare providers, examples of these organizations include healthcare facilities, including hospitals and skilled nursing facilities, pharmacies, claims processors, and other vendors who help us deliver benefits.

Please contact your Regence representative for specific instructions on the trainings, documents, and attestations below.



Medicare Compliance Training and Fraud, Waste, and Abuse Training

We are required to ensure that our providers and organizations complete a Medicare compliance training, and a fraud, waste, and abuse training.

To fulfill this training requirement, your organization has three options: You may complete your own training, a training offered by a third party, or a training offered by Regence.

If your organization has completed Medicare compliance training, or a fraud, waste, and abuse training through another organization, please provide us with proof of completion, and a copy of the training.

If your organization chooses to complete our training, please click on the links below for the two required trainings. After completion, please complete the attestation form and send it to your Regence representative. If you are a newly contracted provider, please complete the training attestation provided with your contract documents.

Thank you for your cooperation. If you have any questions about whether your organization is required to complete these trainings, or whether your organization's internal training or third-party training is sufficient, please contact your Regence representative. If you need assistance or have comments, please email the webmaster.



Code of Business Conduct

CMS expects Regence to share our standards of conduct with our healthcare providers and vendors and either ensure that these entities adhere to our standards or ensure that these entities adopt and follow their own standards of conduct. These standards reflect a commitment to detecting, preventing and correcting non-compliance with Medicare requirements, including detecting, preventing and correcting fraud, waste and abuse.

The following links are to Regence's Code of Business Conduct and Code of Business Conduct Guide, which are our standards of conduct.



Sample Conflict of Interest Disclosure Certification

CMS expects Regence to obtain conflict of interest certifications from our healthcare providers and vendors. Regence is committed to obtaining these certifications to ensure that each provider or vendor requires its managers, officers, and directors responsible for the administration or delivery of Medicare Advantage and Part D benefits to annually sign a conflict of interest statement attesting that the manager, officer, or director is free from any conflict of interest in administering or delivering these benefits.



Ethics, Compliance and Fraud

Regence is committed to ethics, trust, and integrity; complying with all Medicare requirements; and detecting, preventing and correcting fraud, waste and abuse. If you have concerns about ethics, compliance, or fraud, please consult the following resources.

Medicare Compliance
www.regence.com/medicare/compliance.jsp

Anonymous Medicare Compliance Hotline: 877-878-2273


Fraud and Abuse
www.regence.com/legal/fraud-and-abuse.jsp

Fraud Related to Medicare Part D: (877) 479-8477

Fraud Related to Medicare Part C: (800) 548-4850

Fraud NOT Related to Medicare Part C or Part D:

  • Idaho: (800) 323-1693
  • Oregon: (888) 207-4211
  • Utah: (866) 626-8555
  • Washington: (800) 922-4325

Ethics and Compliance
www.regence.com/legal/ethics-and-compliance.jsp