As part of Neighborhood Health Plan of Rhode Island’s (Neighborhood’s) commitment to compliance, we must ensure that the First Tier, Downstream and Related Entities (FDRs) 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 healthcare and related services to our members, and we are therefore responsible for validating that each FDR or Affiliate is in compliance with Medicare-Medicaid program requirements. Each FDR or Affiliate must complete this Attestation in its entirety in order to be in compliance with Neighborhood Health Plan of Rhode Island’s requirements.
Click the links below to learn more about FDRs and Affiliates.
What is an FDR or Affiliate
Instructions:
An authorized representative from each FDR or Affiliate is required to complete the Neighborhood FDR and Affiliate Compliance 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’s (GSA) exclusion screening, and publication of 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.
Step One: Click each of the links below and select the appropriate response for each category. All five items must be completed.
Step Two: Complete the Attestation below.
I certify, as an authorized representative 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, that the statements above are true and correct to the best of my knowledge.
In addition, my organization will maintain supporting documentation for a period of ten years and will furnish this documentation to Neighborhood Health Plan of Rhode Island upon request for monitoring and auditing purposes.