Neighborhood INTEGRITY (Medicare-Medicaid Plan) FDR and Affiliate Compliance and Training Attestation
First Tier, Downstream, or Related Entity (FDR) and Affiliate Compliance and Training Attestation
As part of Neighborhood’s commitment to compliance, we must ensure that the First Tier, Downstream and Related Entities (FDRs) and Affiliates that we contract with are in compliance with applicable state and federal regulations and meet Neighborhood’s requirements for training. As part of Neighborhood’s contract with the Center for Medicare & Medicaid Services (CMS), there are terms, conditions, and requirements that we must adhere to. Our FDRs and Affiliates provide health care and related services to our members, and we are therefore responsible for validating that each FDR and Affiliate is in compliance with Medicare and Medicaid program requirements. Each FDR and Affiliate must complete this Attestation in its entirety in order to be in compliance with Neighborhood’s requirements.
An authorized representative from each FDR and Affiliate is required to complete the Neighborhood FDR and Affiliate Compliance and Training Attestation (on behalf of his or her organization) upon contract and on an annual basis to attest to compliance with the standards of conduct, compliance policies, fraud waste and abuse training, Office of Inspector General (OIG) and General Services Administration (GSA) exclusion screening, and publication of Fraud, Waste and Abuse (FWA) and compliance reporting mechanisms requirements.
An authorized representative is an individual who has responsibility directly or indirectly for all employees, contracted personnel, providers/practitioners, and vendors who provide healthcare or administrative services under Medicaid and/or Medicare. Authorized representatives may include, but are not limited to, a Compliance Officer, Chief Medical Officer, Practice Manager/Administrator, Provider, an Executive Officer or similar related positions.