In the Medicare industry, FDR takes on a different meaning that is not our 32nd president. It stands for First-Tier, Downstream, and Related Entities. You, as an agent, may be considered an FDR. What does it mean?
A First-Tier Entity is anyone who has a written agreement approved by CMS and provides administrative or health care services to Medicare-eligible individuals with MA (Medicare Advantage) or Part D (prescription drug coverage).
A Downstream Entity is anyone who has a written agreement approved by CMS with individuals involved with MA or Part D that is below the level of a First-Tier Entity.
A Related Entity is anyone who is related to an MA or Part D organization/sponsor and performs some management functions, provides service with a written agreement, or leases property or sells materials with a cost of more than $2,500 during a contract period.
If you’re contracted with a carrier as an agent licensed to sell MA or Part D, you are most likely an FDR. What does this mean for you?
The title “FDR” brings special compliance guidelines with it. You may hear the term tossed around in the context of “FDRs need to complete this training” or “FDRs are required to…”
As an FDR, you are required to complete all of your training by 90 days after your hire date and renewed annually. If you do not complete your training, CMS has the right to terminate your contract and stop you from selling. Training includes:
It’s in your best interest to hold on to any verifications and evidence of your certifications and trainings.