Medicare Compliance Program Self-Assessment Tool

This document is a guide for conducting a self-assessment of compliance with the Medicare Compliance Program requirements for First Tier, Downstream, and Related Entities (FDR). The objective is to confirm an organization’s adherence to these requirements as detailed in the FDR Guide. The guide outlines a structured process for reviewing documentation to determine compliance, which includes listing reviewed materials and making notes in designated sections. It emphasizes the importance of conducting root cause analysis for any non-compliance issues and developing corrective action plans. The document also specifies the evaluation methods, including documentation, policy, and sample reviews, to ensure that all necessary compliance elements are met. Additionally, it provides instructions for screening employees and Downstream Entities against exclusion lists and mandates oversight of subcontractors to ensure compliance with Medicare regulations. The guide serves as a comprehensive tool for organizations to assess and ensure their compliance with Medicare standards.