Welcome to AHIA’s Compliance Corner!
We will be posting little known facts that you may or may not have known. We will do our best to keep you up to date on changes in our industry and how it effects you as an agent. If you have any specific questions, concerns or wish to report a compliance issue you may send it anonymously below:
We will do our best to address your issue.
(1-11-2023) CMS Update
The Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.
As of September 2022, 65,103,807 people are enrolled in Medicare. This is an increase of 160,823 since the last report. 34,984,295 are enrolled in Original Medicare. 30,119,512 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage. 50,574,579 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage. Over 12 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs. Detailed enrollment data can be viewed here: https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment
Medicaid and Children’s Health Insurance Program (CHIP) As of September 2022, 90,933,769 people are enrolled in Medicaid and CHIP. This is an increase of 383,357 since the last report. 83,901,601 are enrolled in Medicaid, 7,032,168 are enrolled in CHIP. For more information on Medicaid/CHIP enrollment, including enrollment trends, visit https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot/index.html
Every day, CMS ensures that people across the U.S. have coverage that works. See the latest coverage totals across all CMS programs at https://www.cms.gov/pillar/expand-access. This information is updated on a monthly basis. Enrollment data for CMS programs are compiled on different timelines owing to the unique nature of each program.
(3-1-2023) Compliance Request - Scan Health Plan FDR Attestation
Appendix A – Report an Issue to SCAN Health Plan
FDRs, their employees and first tier, downstream and related entities must report compliance concerns and suspected or actual violations related to the Medicare program to SCAN Health Plan.
SCAN Health Plan will maintain confidentiality of all reports to the greatest extent possible. There are several ways to report potential compliance issues and/or Fraud, Waste and Abuse – to SCAN, to Ethicspoint, and independent organization or to the Office of Inspector General (OIG).
To report a compliance issue, you may contact SCAN in one of these ways:
- SCAN Hotline at EthicsPoint: 1-877-863-3362 or visit www.ethicspoint.com
- Contact OIG: 1-800-HHS-TIPS (1-800-447-8477) or visit https://forms.oig.hhs.gov/hotlineoperations/index.aspx
- Contact SCAN’s Compliance Officer:
Ginette Hawkins – SCAN Compliance Officer
3800 Kilroy Airport Way, Ste. 100
Long Beach, CA 90806