Fraud, Waste and Abuse Training

The Centers for Medicare and Medicaid Services (CMS) requires all Medicare Advantage and Prescription Drug (Part D) health plans to make sure their participating or contracted providers have completed Fraud, Waste and Abuse (FWA) training on a yearly basis. (42 CFR 422.503 and 423.504) New West Health Services is offering the following information to help fulfill this training requirement. Please read the instructions carefully and contact your New West Health Services Provider Services Representative with questions.

All licensed medical professionals, care-givers and office staff and management; health care facility management and health care facility staff that have direct or indirect patient care and/or billing or accounting responsibilities for Medicare beneficiaries; other providers and staff having direct or indirect Medicare beneficiary patient care, billing and/or accounting MUST complete the following training every year or attest to New West Health Services that they have received other similar training from another identified source.

a. Licensed Physicians and Medical Professionals – Must complete an individual attestation form after receiving or reviewing New West’s FWA training. If training was received from or through another source, please complete the individual attestation form, identifying the other source and date received or reviewed.

b. Physician, Medical Professional or Clinic care-givers and office staff – Must complete New West’s FWA training, or the training from another source on a yearly basis. One attestation must be signed on behalf the office or clinic by an officer responsible for compliance functions. Form 2 Proof of training by all care-givers and office staff can be documented on a training log and must be available for CMS should they decide to audit for compliance.

c. Licensed Hospital, Facility or Other Healthcare Provider – Must ensure that all staff providing direct or indirect care, billing or accounting for Medicare beneficiaries has received FWA training every year. One attestation can be signed on behalf of the facility or provider by the President, CEO or other officer responsible for compliance functions. Form 2 Proof of training must be available for CMS should they decide to audit compliance. The training log can be used to document training sessions and kept with other Medicare compliance documents.

If the office, clinic, hospital, facility or provider has completed the FWA training process through another source, an attestation Form 2 is still required to be signed by the President, CEO or other officer responsible for compliance functions, identifying the other source and date training was received.