First Tier, Downstream and Related Entities (FDR) Compliance Requirements

 

The Centers for Medicare & Medicaid Services (CMS) requires that plan sponsors, such as MediGold, ensure their First Tier, Downstream and Related Entities (FDRs) comply with CMS Medicare Program requirements. MediGold's FDR Administrative Manual, found at the link below, provides a summary of MediGold's compliance program requirements and includes MediGold's Standards of Conduct, Compliance policies and procedures, and ways to report suspected noncompliance or Fraud, Waste and Abuse (FWA). The requirements listed apply to you/your organization and the employees assigned to perform services for MediGold.


    Annual FDR Compliance Attestation

    MediGold's First Tier, Downstream and Related Entities (including providers, such as doctors and medical groups) are required by CMS to attest each year that they have satisfied certain compliance program requirements. To meet this compliance requirement, please click on the FDR Compliance Attestation link below and complete the simple attestation form. Failure to complete the attestation form may lead to corrective action. Please print and complete the attestation below and return by mail, email, or fax to:

    ‚ÄčLarry Pliskin
    Compliance Officer
    6150 East Broad Street, Suite EE320
    Columbus, OH 43213-1574
    614-546-3146 – fax
    Larry.Pliskin@mchs.com

    NOTE:  If you contract with an offshore vendor to provide services on behalf of MediGold, you must also complete the following form (please print, fill-in, and submit to MediGold):


    Medicare Compliance and Fraud, Waste and Abuse Training

    CMS requires that all FDRs and their employees who perform services for MediGold complete general compliance and Fraud, Waste and Abuse (FWA) training within 90 days of hire/contracting and annually thereafter. FDRs must complete this training through the CMS Medicare Learning Network (MLN). Please access the link below to complete the training. MediGold or CMS may request proof of training completion. Completed attestation or training logs must be made available for review, upon request.

    CMS Medicare Learning Network Compliance/FWA Training (Please access the link to complete the training. By clicking this link, you will be leaving the MediGold website.)

    In order to access the training, you will need to scroll toward the bottom of the webpage (at the link above) and select "Web-Based Training (WBT) Courses". If you have not already done so, you will need to create a new MLN account. Once your account is created, you can access the training, which is available under the Provider Compliance category.

    Updated 02/2016