Action Required Regarding 2016 CMS Mandatory Trainings
Date: 03/08/16
Action Required Regarding 2016 CMS Mandatory Trainings
Dear Sunshine Health Provider,
The Centers for Medicare and Medicaid Services (CMS) require that Medicare Advantage Organizations inform network providers and practitioners about the requirements to complete annual training. In 2016, the required trainings are:
Model of Care (MOC)
General Compliance (Compliance)
Fraud, Waste, and Abuse (FWA)*
For General Compliance and Fraud, Waste, and Abuse*: effective January 1, 2016, First-Tier, Downstream, and Related Entities (FDR), as well as delegated entities, will be required to complete training via the Medicare Learning Network (MLN) website. The trainings must be completed by each individual provider/practitioner within the group rather than one person representing the group collectively. The updated regulation requires all applicable entities (providers, practitioners, administrators) to complete the training within 90 days of contracting or becoming a delegated entity andannually thereafter. Once the training is completed, each applicable entity will need to complete the certificate(s) of completion or attestation through the CMS MLN and provide a copy to Sunshine Health.
*Note: FDR’s deemed to have met the FWA training and education certification requirements through enrollment into Parts A or B of the Medicare program or through accreditation as a supplier of DMEPOS are exempt from the FWA training requirement only (General Compliance training remains a requirement)
To complete Compliance and FWA training (if applicable) and access your certificate of completion:
- Visit the CMS MLN site:
To access training, use the following link and refer to the “Downloads” section of the webpage:
- Please provide Sunshine Health a copy of each certificate of completion:
Email to: compliancefl@centene.com
Fax to: 1-866-796-0540
For Model of Care (MOC), the training should be accessed at www.sunshinehealth.com/for-providers/provider-resources. Once the training is completed, please fill out the attestation form located at the end of the presentation and submit. Attestation forms can be completed and submitted online. Please note that when you complete the attestation form, remember to include all tax identification numbers (TIN) that you are representing.
| Training | Training Location | Signed Attestation(s) From | Attestation Method |
|---|---|---|---|
| Model of Care | Sunshine Health's Website: www.sunshinehealth.com | Representative may attest for group or organization (TIN level) | Complete the electronic attestation form on Sunshine Health’s website at the end of the training presentation |
| General Compliance | CMS MLN | Each applicable provider, practitioner, administrator (entities classified as FDR) | Send a copy of the CMS certificate of completion to Sunshine Health at: compliancefl@centene.com |
| Fraud, Waste and Abuse | CMS MLN | Each applicable provider, practitioner, administrator (entities classified as a FDR provided they are not exempt – see *note above) | Send a copy of the CMS certificate of completion to Sunshine Health at: compliancefl@centene.com |
Sunshine Health is committed to working with you to fulfill these CMS requirements. If you need additional information, please feel free to contact Provider Services at 1-866-796-0530.
Thank you for your participation. We look forward to working with you to provide quality medical services and healthcare coverage to our Sunshine Health Advantage (HMO SNP) members.
Sincerely,
Sunshine Health