| Date: | July 24, 2019 |
| To: | Health Plan of San Joaquin (HPSJ) Providers  |
| From: | HPSJ Provider Networks Department |
| Subject: | CMS-Required Fraud, Waste, and Abuse (FWA) Training for HPSJ Providers |
| Business: | Medi-Cal |
Health Plan of San Joaquin, as a licensed health care services plan regulated by the Department of Managed Health Care (DMHC) and contracted with the Department of Health Care Services (DHCS), is committed to protecting members, our network of providers, and public interests by preventing, detecting, investigating, correcting, and reporting Fraud, Waste, and Abuse (FWA).
Under legal requirements overseen by the federal Centers for Medicare & Medicaid Services (CMS), 42 C.F.R. §422.503 and 42 C.F.R. §423.504, you are required to either complete the FWA training offered on the HPSJ website and send HPSJ a signed attestation, or attest that you have completed another, acceptable FWA training.
Training Resources Available for You
To help you meet the annual FWA training requirement, Health Plan of San Joaquin is now providing this training, at www.hpsj.com/fraud-waste-and-abuse-prevention-training.
Attestation Process
By Monday, September 30, 2019, please complete and digitally sign the attestation form.
The attestation form is also included with the online training on the HPSJ website (www.hpsj.com/fraud-waste-and-abuse-prevention-training). It requires your signature to:
- Attest to receipt of these training materials
- Confirm you have completed review of these materials
- Acknowledge you have taken part in a FWA training
FWA-Related Services are available on the CMS website:
Unfortunately, FWA in health care is prevalent and expensive. Although there are no precise measures, it is estimated FWA in government health care services programs costs taxpayers billions of dollars every year. Not only is this a waste of funds, it can also effect HPSJ member safety, and access, and cause care issues. As always, we appreciate your partnership, including the timely completion of training in the fundamentals of health care FWA prevention, detection, and correction.
If you have any questions, please contact our Customer Service staff at 209.942.6320