Medicare first-tier, downstream and related entities

Providence Health Assurance (PHA) is contracted with The Centers for Medicare & Medicaid Services (CMS) to provide health care and prescription drug coverage to our Medicare beneficiaries. These beneficiaries are PHA’s valued members. As a condition of our contract with CMS, PHA is required to provide and oversee the below training and educational presentations that are given to our contracted providers, vendors and related entities that provide service to our members. These providers, vendors and related entities are PHA’s first-tier, downstream and related entities, also known as FDRs.

Thank you for your service to our members. We appreciate your partnership with Providence Health Assurance. If you have a compliance question, please email us at PHAMedicareCompliance@providence.org.

CMS requires that FDR’s receive general compliance and fraud, waste and abuse training upon hire and annually thereafter.

In order to successfully meet our training obligation (42 CFR §422.503 (b)(4)(vi)(C)(3) and §423.504 (b)(4)(vi)(C)(3)) with CMS, please complete one the following steps.

You will be asked to attest during your annual FDR Attestation.

Please review the required documents. Once you have completed the MA Compliance and Fraud, Waste and Abuse training and pass the post-test you will receive an email confirmation. Please download your certificate and keep for your records. If you have any additional questions regarding this required training please contact your PHA provider representative.

Conflict of interest

Providence Health Assurance’s expectation of all FDRs is that they should have a conflict of interest process in place for all employees that work with the PHA line of business.

Policy and procedures