Medicare Part D

Medicare Advantage Drug Plans (MAPDs) and Prescription Drug Plans (PDPs) face tightening compliance requirements at the same time they are confronted by a shrinking pool of eligible enrollees and qualified sales agents, an expanding number of competing plans, and pressure to control costs. Kaplan EduNeering works with health plans to assure the compliance and productivity of employees, brokers, agents and downstream entities defined by CMS.

KnowledgeWire®, our robust learning management system meets the Best Practice recommendations from CMS. The system enables the distribution, validation of receipt by e-signature, testing and documentation of all training activities in audit- ready format. Our hosted solution enables non-employees to access training without passing through the company’s firewall, ensuring both optimal security and control over infrastructure use. Our library of healthcare-specific courses comply with CMS requirements and target those areas identified by CMS as posing particular risk of noncompliance. Courses are constantly updated to reflect the most current CMS requirements, such as the 2009 requirement that all Compliance Programs include training about Fraud, Waste and Abuse. Additional courses focus on related issues including the False Claims Act, ethics and integrity, human resources and employee protections, as well as compliance issues regulated by other agencies such as SEC and OSHA. Customized courses focus on company-specific needs such as Codes of Conduct, corporate policies and procedures, and regulatory updates.

Kaplan EduNeering has developed a specialized curriculum to address the industry’s specific sales and marketing requirements and regulations. The intensive scrutiny focused on health plan sales and marketing organizations has led many leading Part D companies to implement enterprise-wide training programs to assure enrollee satisfaction and risk management. Among the topics of particular importance are plan-specific features and limitations, patient confidentiality, and professional relationships with downstream entities including pharmaceutical companies, doctors and other medical professionals, pharmacies and Pharmacy Benefit Managers (PBMs). Our training materials incorporate advanced instructional design techniques including simulation, interactivity and gaming to promote interest, engagement and comprehension.
Kaplan EduNeering assists companies meet both compliance and performance goals related to issues including:

MAPD, PDP, PFFS compliance training
Broker and Agent Training
Fraud, Waste and Abuse (FWA)
Hotlines to report FWA or other violations
False Claims Act
Plan-specific training
Financial relationships with downstream entities