The list in Chapters 9 and 21 provide examples of reports that Sponsors should receive, and seem to be focused on identifying fraud, waste, and abuse. Should the Sponsor receive similar reports from its FDRs as it relates to ongoing compliance with Medicare C/D operational functions (i.e., enrollments, organization/coverage determinations, appeals, grievances, call center compliance, etc.) that have been delegated to a first-tier or downstream entity?
Yes. The list of reports in Chapters 9 and 21 are only examples of the many kinds of
reports a sponsor may wish to obtain from its FDRs. The reports the sponsor obtains from the
first tier entity depend upon the function being performed.
