COMPLIANCE REQUIREMENTS
American Specialty Health Fitness, Inc. (ASH Fitness) contracts with Medicare Advantage and Medicaid Managed Care plans to provide fitness benefits to their members. Because these programs are paid for with federal and/or state tax dollars there are specific compliance requirements that the Medicare Advantage and/or Medicaid Managed Care plans require ASH and its contracted fitness centers/instructors meet.To satisfy these requirements, ASH requires its contracted fitness centers/instructors and its key employees to fulfill the below compliance requirements. Please refer to the “Compliance with Medicare and Medicaid Programs” section of your Program Manual for the definition of a key employee.
COMPLIANCE REQUIREMENT TIMELINE
| Owner/Manager Requirements | |
|---|---|
|
Within 90 days of Contracting with ASH Fitness
|
Complete Section 1 & 3 |
| Prior to hire of a new employee | Complete Section 2 |
| Annually | Complete Sections 1, 3 & 4 |
| Monthly | Complete Section 2 |
| All Key Employee Requirements | |
|---|---|
| Within 90 days of Fitness Center or Instructor Contracting with ASH Fitness (existing employees) | Complete Sections 1 & 3 |
| Within 90 days of hire | Complete Sections 1 & 3 |
| Annually | Complete Sections 1 & 3 |
1. FRAUD, WASTE, ABUSE AND GENERAL COMPLIANCE
Required for existing owners, managers and key employees within 90 days of contracting with ASH Fitness and annually thereafter.
Required for new key employees within 90 days of hire and annually thereafter.
2. Exclusion from Medicare and Medicaid Checks
Required for owners and managers monthly and prior to hire of new key employees.
Exclusion Checks
Review Exclusion Checks Guide
Complete Exclusion from Medicare and Medicaid Checks Monthly Log & Roster
Exclusion Checks Websites
www.sam.gov
https://exclusions.oig.hhs.gov
3. ASH POLICIES
Required for existing owners, managers and key employees within 90 days of contracting with ASH Fitness and annually thereafter.
Required for new key employees within 90 days of hire and annually thereafter.
Code of Conduct & Ethics
Review
Code of Conduct & Ethics Program
Reporting Issues of Noncompliance
Compliance Issues Reporting Form
4. CONSOLIDATED ATTESTATION
Required annually for owners and managers.
5. RETAIN RECORDS
You are required to maintain a copy of the Employee Roster for Medicare Training, Exclusion from Medicare Checks Monthly Log & Roster and the signed Consolidated Attestation for a period of at least 10 years.