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Fraud, Waste and Abuse (FWA) & General Compliance TrainingTest

It is required that all organizations/offices train all personnel within 90 days of hire, and on an annual basis thereafter on Fraud, Waste, and Abuse and General Compliance. My organization/office has satisfied this requirement for contract year 2018 via:

FWA and General Compliance (Select only ONE)*


Company's FWA and General Compliance Training that follows CMS Material (ie HealthStream)CMS Medicare Learning Network (MLN) FWA training and General Compliance education modules, with certificates of completion available upon request.My organization/office has met the FWA certification requirements through enrollment into the Parts A or B of the Medicare program or accreditation as a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS); therefore, my organization/office is considered deemed and exempt from completion of FWA training, but ensures general compliance training is provided to all employees. CMS Medicare Learning Network (MLN) General Compliance education modules, with certificates of completion available upon request.

Compliance Information – Standards of Conduct

Providers and employees have read and agree to comply with (select only ONE)*

Tuality Healthcare’s Standards of Conduct.Our own Standards of Conduct that meet CMS’s requirements.

Employee OIG and SAM Exclusion Lists

Exclusion logs must be kept and include employee name, date each database was checked and whether or not an exclusion was found. These logs must be made available for review, upon request. THA Providers have already satisfied this requirement. (OIG: https://exclusions.oig.hhs.gov | SAM: https://www.sam.gov/ ) Please select one of the following methods for ensuring compliance with exclusion lists:
Exclusion Lists*

My organization/office reviews the exclusion lists prior to hire and monthly thereafter for employees and staff.All employees and staff are employed by Tuality Healthcare and have met this requirement.

Provider Manual

All providers read and agree to comply*

All Providers have read and agree to comply with the Tuality Health Alliance Provider Manual ( can be found on the THA website )

Restraint and Seclusion

Please select one of the following methods for ensuring compliance with Restraint and Seclusion*

We have supplied Tuality Health Alliance with our policies and/or procedures pertaining to Restraint and Seclusion.We have supplied Tuality Health Alliance with a Restraint and Seclusion waiver, as we do not practice Restraint and Seclusion within our office.

Signature


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Enter the tax identification number (TIN)


Please electronically sign this by entering your name.

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