Compliance program guidelines
Medicare Prescription Drug Benefit Manual (Chapter 9) and Medicare Managed Care Manual (Chapter 21)
This information provides interpretive guidelines to help all Plan Sponsors to establish/maintain an effective compliance program to prevent, detect and correct any government program noncompliance.
These guidelines, published in both Pub. 100-18, Medicare Prescription Drug Benefit Manual, chapter 9 and in Pub. 100-16, Medicare Managed Care Manual, Chapter 21, are identical and allow organizations offering both Medicare Advantage (MA) and Prescription Drug Plans (PDP) to reference the document for guidance. This link is provided for reference or informational purposes only. (You are not required to print and provide this as part of training).
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