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2021 UnitedHealthcare Community Plan of Kentucky Evidence-Based Practices Survey/Attestation |
IMPORTANT NOTE:
As part of the UnitedHealthcare Community Plan of Kentucky commitment to compliance, UnitedHealthcare Community Plan of Kentucky must ensure that Behavioral providers who contract with us are in compliance with applicable state and federal regulations. As part of UnitedHealthcare's contract with the Department of Medicaid Services, the Cabinet for Health and Family Services, UnitedHealthcare Community Plan of Kentucky is responsible for validating that each contracted provider is in compliance with Medicaid program requirements. Each contracted provider must complete this Attestation in its entirety in order to be in compliance with UnitedHealthcare Community Plan of Kentucky's requirements and render services to Medicaid members.
INSTRUCTIONS:
An authorized representative from each First Tier, Downstream and Related Entities (FDR) or Affiliate is required to complete the UnitedHealthcare Community Plan of Kentucky FDR and Affiliate Compliance Attestation (on behalf of his or her organization) upon contract and annually and thereafter to attest to compliance with the use of Evidence-Based Practices (EBPs) that meet standards of national models in all behavioral health services.
INSTRUCTIONS:
An authorized representative from each First Tier, Downstream and Related Entities (FDR) or Affiliate is required to complete the UnitedHealthcare Community Plan of Kentucky FDR and Affiliate Compliance Attestation (on behalf of his or her organization) upon contract and annually and thereafter to attest to compliance with the use of Evidence-Based Practices (EBPs) that meet standards of national models in all behavioral health services.
- An authorized representative is an individual who has responsibility directly or indirectly for all employees, contracted personnel, providers/practitioners, and vendors who provide healthcare or administrative services under Medicaid and/or Medicare. Authorized representatives may include, but are not limited to, a Compliance Officer, Chief Medical Officer, Practice Manager/Administrator, Provider, an Executive Officer or similar related positions.
- This attestation must be completed for each practice location where healthcare or administrative services are provided for Medicaid and/or Medicare members.