First tier, Downstream and Related entities (FDRs) Resources
Security Health Plan’s commitment to compliance includes ensuring that our contracted business partners who are FDRs under the Medicare Advantage program also observe all applicable laws, regulations, and sub-regulatory guidance. Oversight of FDRs is a CMS requirement for all Medicare Advantage plan sponsors.
The CMS training includes, but is not limited to the following:
HEAT Provider Compliance Training Videos and Audio Podcasts
Preventing Fraud, Waste & Abuse – The Office of Inspector General’s (OIG) mission is to protect the integrity and welfare of the program and for the program beneficiaries. Below is a useful OIG widget to provide our partnering physicians and subcontractors with the information and training as it pertains to fraud and abuse.
Eye on Oversight: Exclusions
The HHS OIG has authority to exclude, or ban, individuals and entities from participating in Federal health care programs. Employers must check that they are not employing an excluded individual because they may face a financial penalty. This video also covers OIG’s exclusions database, and possible reinstatement.
Disclaimer: These educational materials were current at the time they were published and posted to Security Health Plan's Web site. They were prepared as educational resources; they are not intended to create any rights, privileges, or benefits. Although every reasonable effort has been made to ensure the accuracy of the information within these materials, the ultimate responsibility for complying with Federal and state laws lies with the provider of services. Security Health Plan employees, agents, and staff make no representation, warranty, or guarantee that these compilations of information are error free and will bear no responsibility or liability for the results or consequences of their use. These materials are summaries that explain certain aspects of the laws, but are not legal documents. The official information is contained in the relevant laws and regulations.