Medicare Part D: The Medicare prescription drug benefit program. We call this program “Part D” for short. Medicare Part D covers outpatient prescription drugs, vaccines, and some supplies not covered by Medicare Part A or Medicare Part B or Medical Assistance. Our plan includes Medicare Part D.Medicare Part A: The Medicare program that covers most medically necessary hospital, skilled nursing facility, home health, and hospice care.
Medicare Part B: The Medicare program that covers services (such as lab tests, surgeries, and doctor visits) and supplies (such as wheelchairs and walkers) that are medically necessary to treat a disease or condition. Medicare Part B also covers many preventive and screening services.Medical Assistance: This is the name of Minnesota’s Medicaid program. Medical Assistance is run by the state and is paid for by the state and the federal government. It helps people with limited incomes and resources pay for long-term services and supports and medical costs.
It covers extra services and some drugs not covered by Medicare. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Fraud, Waste and Abuse

South Country is committed to identifying, preventing, correcting, and reporting fraud, waste and abuse. The efforts undertaken as part of these processes are collaborative in nature and involve training and education, monitoring, audits including automated claims system checks, membership and participation in the Minnesota Healthcare Fraud Taskforce, and more. All activities are consistent with applicable laws, regulations and government health care program requirements.

It is the responsibility of all employees, governing board members, and first tier, downstream, and related entities (FDRs) to immediately report suspected fraud to the Compliance Department or by calling the Compliance Hotline. We also strongly encourage our member counties and participating providers to report any suspected fraud.

In accordance with established policies and procedures, South Country is authorized to investigate allegations of fraud concerned with all lines of business and involving providers, members, group representatives, employees, or other individuals or groups.

Links on this page provide information relating to Medicare training courses, fraud, waste and abuse, the Deficit Reduction Act, and a link to the Compliance Hotline, Report It. More information on the annual training requirements for FDRs can be found in the FDR Compliance Guide.

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