Select language
Español

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.

Download PDF

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

Download PDF

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

[[[["field28","contains","Other Organization"]],[["show_fields","field26,field51,field46,field52"]],"and"],[[["field44","equal_to","I am the only provider at my practice"]],[["hide_fields","field43"]],"and"]]
1

Annual Network Provider Anti-Fraud, Waste & Abuse
Training Acknowledgment & Attestation

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, providers and their employees are required to annually complete the FWA training offered on the HPSJ website or complete another, acceptable FWA training and provide proof of training. Proof can be a certificate of completion, training program outline, or web link to the training. After choosing one of the training options, providers must attest for themselves and their employees who completed the training by completing the attestation below.



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

Training Option 1:

Training Option 2:

I

attest to having received the annually required Network Provider Anti-Fraud, Waste, & Abuse Training and resources for the Medi-Cal/MediCaid program.

Provider/Authorized Signature

I agree to the terms and conditions
(Sign Here)
Clear Signature

Please send this completed form to HPSJ at providernetworks.verification@hpsj.com and fax 209-933 3700

 This training is required for all providers and their staff. Please list all providers and staff who also completed the training down below


Provider & Employee Name (First and Last)
Provider Individual NPI#
keyboard_arrow_leftPrevious
Nextkeyboard_arrow_right

Posted on July 5th, 2019 and last modified on June 12th, 2023.

top
X