Banner Medicare Advantage is committed to ethical and legal conduct. This includes meeting the obligations of programs involving the delivery of health care services. Banner Medicare Advantage is a Medicare participant.
A key component of our commitment to meeting our obligations under governmental programs and contractual relationships includes adopting standards that uphold these principles, which is the basis for this Compliance Program. The Compliance Program is described in several documents including the Code of Conduct, policies and procedures, as well as the Fraud, Waste, and Abuse Plan.
All employees and the Governing Bodies as well as first tier, downstream and related entities, subcontractors, Providers and agents (Business Partners) must make a personal commitment to adhere to the Code of Conduct. Please review our Compliance Program and Fraud, Waste and Abuse Plan (January 1 through December 31), which includes the Banner Medicare Advantage code of conduct.
Banner Medicare Advantage is committed to compliance and meeting requirements of all applicable laws and regulations of CMS. As part of our compliance program, please review the FDR Guide to help ensure your compliance with CMS, and Banner Medicare Advantage requirements.
Banner Medicare Advantage General Compliance and FWA training is now available on our website. FDRs can take our training or a comparable training. FDRs are required to complete an attestation and submit it to BMA indicating that the employees involved in the administration of Medicare Part C and D benefits have satisfied the training requirement. In addition, the following are required training elements:
Documentation of internal training can be through an individual certificate or a list showing the information for all of those who completed it through the internal web-based training.
The Compliance Departments or Vendor Oversight Staff track completion of training by FDRs through the completion and collection of annual attestations from all FDRs.
CMS requires providers who are caring for Special Needs members to be trained on the Model of Care (MOC) annually. If you provide care to our Banner Medicare Advantage HMO D-SNP members, please complete the training below.
Please complete the Model of Care Training. Following the training, complete your attestation online.
Have questions? Contact our Provider Experience Center (PEC) by phone at (877) 874-3930 x 2 or by email at [email protected].
The Code of Conduct states Banner Medicare Advantage's over-arching principles and standards by which Banner Medicare Advantage operates and defines the underlying framework for the compliance policies and procedures. Staff, Providers, and Business Partners, from the top to the bottom of our organization, have the responsibility to perform their duties in an ethical manner in compliance with laws, regulations and Banner Medicare Advantage policies.
Banner Medicare Advantage requires that all FDRs supporting the Medicare Advantage and Part D Prescription Drug Program adopt and abide by the Banner Medicare Advantage Code of Conduct or implement a Code of Conduct that incorporates standards of conduct and requirements consistent with Banner Medicare Advantage's Code of Conduct.
All Banner Medicare Advantage Staff and Business Partners must read the Code of Conduct annually and sign an acknowledgement that they agree to abide by the Code of Conduct.
Contact our Compliance Department with any questions and/or to report potential compliance issues and fraud, waste, and abuse.
ComplyLine (Confidential and Anonymous): (888) 747-7989; 24 hours a day/7 days a week
Email: [email protected]
Fax: (520) 874-7072
Director, Corporate Compliance
Contracted providers and Subcontractors, with Banner Medicare Advantage are required to complete the Annual Attestation and Disclosure Statement.
1. Review each section
2. Complete the 2024 Annual Compliance Attestation online here: https://eservices.uph.org
*If you are unable to complete the online form above, below is the PDF version.
Banner Medicare Advantage is committed to preventing Fraud, Waste, and Abuse (FWA).
If you suspect a provider or member of fraud and abuse, please contact us at any of the following methods:
Banner Medicare Advantage Dual (877) 874-3930, TTY 711
Banner Medicare Advantage Prime: (844) 549-1857, TTY 711
Banner Medicare Advantage Plus: (844) 549-1859, TTY 711
ComplyLine (Confidential and Anonymous): (888) 747-7989; 24 hours a day/7 days a week.
Banner Plans and Networks
5255 E Williams Circle, Ste 2050
Tucson, AZ 85711
Member Fraud, Waste, and Abuse include, but are not limited to:
Provider Fraud, Waste, and Abuse include, but are not limited to:
BMA has written policies in place to: