Annual Compliance Checklist for Chiropractic Providers
It is often a difficult and tedious task for providers to know what is required of them each year from the various carriers they are contracted with.
To make things easier, Fulcrum has developed an Annual Compliance Checklist for Chiropractic Providers to help providers and their offices identify and easily locate important items that are required by Fulcrum and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS). This checklist identifies what items are required each year and provides direct links to where the information can be found.
Compliance and Fraud, Waste and Abuse Training
As of January 1, 2016, the Centers for Medicare and Medicaid Services (CMS) regulations require all first tier, downstream, and related entities (FDRs) to complete general compliance and fraud, waste and abuse (FWA) training within 90 days of hire/contracting. This training is good for one calendar year and needs to be completed annually. FDRs include providers and staff.
To help FDRs complete this training, CMS has created a FWA training module. CMS requires FDRs to complete this training and has presented two options to meet this requirement:
- A FDR may complete the general compliance and FWA trainings on the CMS Medicare Learning Network. After completing the training, the trainee must enter their name and date into the generated certificate which can then be printed off and saved for a minimum of 10 years, per CMS.
- The general compliance and FWA trainings through CMS can be used in addition to an existing training in the organization. Please note that the CMS trainings cannot be edited in any shape/way/form to ensure that the necessary information is being conveyed. The trainee must complete the certificate from the CMS training and retain the record for a minimum of 10 years.
Special Needs Plans Training
Required Provider Training: Dual-Eligible Products
HealthPartners and UCare sell dual-eligible products that qualify as Special Needs Plans (SNPs), e.g., Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+). Due to the unique makeup and needs of SNP members, plans are required to submit a Model of Care (MOC) plan that includes product-specific provider training for these products.
In compliance with the HealthPartners and UCare MOCs, ChiroCare providers are required to review each plans’ SNP training materials and share with appropriate clinic staff. The training deadline is December 31, 2016, and the training is an annual requirement.
To comply with this provider requirement, this web page was developed to host training materials and a Special Needs Plan Training Log tracking. Below are the training presentations for HealthPartners and UCare. HealthPartners is a PDF, and UCare is a link to their training site.
Remember, it’s important to retain a completed tracking sheet of individuals who have completed training in order to demonstrate compliance if needed due to audit.
UCare MSHO MSC+ Model of Care Training Presentation and Slides | Web Link
Please note – this requirement can be fulfilled by viewing the plan’s recorded webinar. The training materials can be accessed by using the link above and scrolling half way down the UCare web page under the sub-heading labeled 2016 MSHO Model of Care. You may be prompted to install a WebEx Network Recording Player in order to view the webinar presentation. If technical issues hinder you from viewing the webinar, a detailed review of the presentation slides can be done instead.