PPS Partner Attestation of Compliance Education and Training

As a lead entity in the DSRIP Program, Refuah Community Health Collaborative is required to have an effective compliance program in place to ensure Medicaid payments are not connected in any way with non-compliant behavior or fraud, waste, and abuse. All Refuah CHC partners are responsible for ensuring that their DSRIP-related activities comply with all applicable laws, rules, and regulations of the DSRIP Program. Each Partner and their respective DSRIP related staff are required to follow Refuah CHC’s Standards of Conduct and complete the compliance training and education PDF located below. Each partner must also sign the below attestation once the training is complete. A partner will have 30 days to complete the training and sign the attestation. Please note, Refuah CHC’s compliance training and education are in addition to a partner’s own compliance obligations under the law.

 

 

  • Attestation

    By completing this form, I attest that I have been designated by the organization or practice named below as the person responsible for providing this attestation, and I am authorized to make the following representations on behalf of my organization or practice.
  • By entering my digital signature below, I am attesting that the information provided is accurate and truthful to the best of my knowledge. I have undertaken due diligence and conducted reasonable inquiry prior to completing this attestation.