Required Training:
Fraud, Waste, and Abuse & General Compliance Training
The Centers for Medicare & Medicaid Services (“CMS”) require Health Plans to Provide Fraud, Waste and Abuse (“FWA”) and General Compliance Training to their contracted first-tier, downstream and related entities (“FDRs”); as well as FDRs employees who are involved in administration or delivery of Medicare Part C and D and Medicaid benefits. This annual training must be completed and attested to. HealthSmart MSO and its contracted IPA’s utilize the Industry Collaboration Effort (“ICE”) Medicare (and Medicaid) Compliance and Fraud/Waste/Abuse Training:
- IPA Attestation Form – Associated Dignity Medical Group, Inc.
- IPA Attestation Form – Angeles-IPA, A Medical Corporation
- IPA Attestation Form – California Pacific Physicians Medical Group, Inc.
- IPA Attestation Form – Healthy New Life Medical Corporation.
- IPA Attestation Form – Noble Community Medical Associates, Inc, Of Mid-Orange County
- IPA Attestation Form – Orange County Advantage Medical Group, Inc.
- IPA Attestation Form – Regent Medical Group, Inc.
- IPA Attestation Form – Southland Advantage Medical Group, Inc.
- IPA Attestation Form – United Physicians International, Inc.
- DHCS Medi-Cal APL 19-001 – Effective 07-01-2019
- HICE Health Care Fraud and Abuse
- HICE General Compliance
- Health Insurance Portability & Accountability
- Compliance Program Standards of Conduct/Code of Conduct
- Early and Periodic Screening, Diagnostic and Treatment Services for Medi-Cal members under the Age of 21-
Memorandums of Understanding for Targeted Case Management (TCM) and Specialty Mental Health Services (SMHS)
View the training and submit attestations in one of the following ways:
Individual Attestations:
View the course PDF and sign the attestation at the end. Or, distribute the course PDF to practitioners in your group.
Practitioners view the PDF and click the attestation link at the end of the course to gain completion.
Group Attestations:
Group administrator distributes the course PDF to practitioners in the group.
Group administrator downloads the MOU Group Attestation spreadsheet and follows the instructions on the first tab in the file.
Group administrator emails the completed Group Attestation spreadsheet to provider_education@blueshieldca.com.
APL 23-029 MOU Training Requirement For:
- Targeted Case Management (TCM): Review TCM Training and submit TCM.
- Specialty Mental Health Services (SMHS): Review SMHS Training and submit SMHS.
Transgender, Gender Diverse, and Intersex Cultural Competency
- Transgender, Gender Diverse, and Intersex Cultural Competency Training
- IPA Attestation Form – Angeles-IPA, A Medical Corporation
Access and Availability
We are committed to ensuring patients receive health care services in a timely manner applicable to the patient’s condition. Our access and availability standards are based on the Department of Managed Health Care (DMHC) regulatory and National Committee of Quality Assurance.
All Primary Care and Specialist Physicians are responsible for providing timely appointment and telephone access to all patients.
Please submit your signed Attestation for your Entity to: Compliance@healthsmartmso.com or Fax (714) 947-8708