Annual Network Provider Anti-Fraud, Waste & Abuse

Training Acknowledgement & Attestation

Fraud, Waste and Abuse Prevention Training

Instructions: Please watch the full video before filling out the form below. If you need additional reading time, you can pause and play the video at any time.

Please fill out the form

Instructions: After watching the video above, please sign the form attesting to have received the annually required Network Provider Anti-Fraud, Waste & Abuse Training and resources for the Medi-Cal/Medicaid program. * Please fill out all required fields

An Authorized Person can complete the training attestation on behalf of your practice for each provider

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Annual Network Provider Anti-Fraud, Waste & Abuse

Training Acknowledgement & Attestation


Health Plan of San Joaquin, as a licensed health care services plan this training is mandated by California’s Department of Health Care Services (DHCS) and the Federal Centers for Medicare and Medicaid Services (CMS) to ensure providers and delegated entities are meeting the unique and diverse needs of all members. As part of new federal requirements, Cultural Competency training will be noted in the Provider Directory.


Under legal requirements, Title 22, California Code of Regulations (CCR) Sections, 53876(a)(4), 53876(c), 53851(b)(2), 53851(e), 53853(d), 53910.5(a)(2); Title 28, CCR, Section 1300.67.04(c)(1)(A) through (B); and Title 42, Code of Federal Regulations (CFR), Sections 438.206(c)(2), 438.330(b)(4), 438.242(b)(2) Health Plan of San Joaquin is required to provide annual Cultural Competency training to our participating provider network and delegated entities. Providers are required to either complete the training offered on the HPSJ website or another health plan and send HPSJ a signed attestation.


An Authorized Person can complete the training attestation on behalf of your practice
for each provider listed on page 2.





Please select the training option you have completed


,attest to having received the annually required Network Provider Cultural Competency Training.

Note: Please make sure you write a visible signature using your mouse or finger in the signature area. 



Provider/Authorized Signature
(Please Sign Here)
Clear Signature

Please list all providers name & individual NPI# below”

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Posted on July 5th, 2019 and last modified on September 7th, 2021.

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