Provider Attestation

Completing this annual attestation confirms acknowledgement of receipt and distribution of the established compliance policies, procedures, and Standards of Conduct in accordance with the requirements outlined in the FDR Program Guide including conflict of interest, record retention, training, and exclusions.

To increase efficiencies and response times, faxes and emails are unable to be accepted for submissions. Attestations must be submitted electronically below.

If the attestation includes multiple TINs, please enter up to 5 TINs per attestation.

NOTE: Submissions received after December 31, 2025 will be accounted for the 2026 attestation period.

The CMS Medicare Learning Network provides Fraud, Waste, and Abuse Training as a resource.

Failure to meet the CMS Medicare compliance program requirements may lead to:

• Education and retraining
• Development of a corrective action plan
• Termination of your contract

For additional information, please refer to our First Tier Downstream or Related Entities site for FDR program resources.