Certification of Data That Determine Payment Requirements

130 - Certification of Data That Determine Payment Requirements (Rev. 79, Issued 02-17-06, Effective Date 02-17-06) As a condition for receiving a MA related monthly payment from CMS, the MAO agrees that its chief executive officer (CEO), chief financial officer (CFO), or an individual delegated the authority to sign on behalf of one of these officers, and who reports directly to such officer, must request payment under the contract on a document that attests to (based on best knowledge, information and belief, as of the date specified on the certification form) the accuracy, completeness, and truthfulness of relevant data that CMS requests. Such data include specified enrollment/disenrollment information, changes in benefit packages, and other information that CMS may specify. The CEO, CFO, or an individual delegated the authority to sign on behalf of one of these officers, and who reports directly to such officer, must attest to the fact that each enrollee for whom the organization is requesting payment is validly enrolled in an MA plan offered by the organization, and the information relied upon by CMS in determining payment (based on best knowledge, information, and belief as of the date specified on the attestation form) is accurate, complete, and truthful. The CEO, CFO, or an individual delegated with the authority to sign on behalf of one of these officers, and who reports directly to such officer, must attest to (based on best knowledge, information and belief, as of the date specified on the attestation form) that the data it submits are accurate, complete, and truthful. If such data are generated by a related entity, contractor, or subcontractor of an MAO, such entity, contractor, or subcontractor must similarly attest to (based on best knowledge, information, and belief, as of the date specified on the attestation form) the accuracy, completeness, and truthfulness of the data. The CEO, CFO, or an individual delegated the authority to sign on behalf of one of these officers, and who reports directly to such officer, must attest to (based on best knowledge, information and belief, as of the date specified on the attestation form) that the information in its bid submission is accurate, complete, and truthful and fully conforms to the bid proposal requirements. This attestation requirement is applicable to all MA contractors, including those that are nonrenewing or terminating their contracts.