Provider Compliance Attestation Requirements

All PrimeWest Health-contracted providers must meet relevant performance, operational, and contractual compliance requirements. These requirements include the following:

  1. Reporting Mechanism. Provider organizations must communicate to employees how they can report suspected or detected noncompliance or potential Fraud, Waste, and Abuse (FWA) without fear of retaliation or intimidation. Employees must have the ability to report concerns directly to PrimeWest Health or to their employer confidentially and anonymously.
  2. Operational Oversight. Provider organizations must conduct internal oversight of the services that are performed for PrimeWest Health to ensure that the services are compliant with applicable laws, rules, and regulations.
  3. Business Continuity Plan (BCP). Provider organizations that provide priority services must maintain a BCP that is followed during a pandemic or state of emergency. Priority services means those services that must remain uninterrupted to ensure the life, health, and/or safety of patients; medical emergency services; post-stabilization care services; urgent care; or other medically necessary services that may not be interrupted for delayed for more than 14 days. If you are unsure or have questions about whether you provide priority services, contact PrimeWest Health’s Provider Contact Center at 1-866-431-0802. The call is free.
  4. Model of Care. Providers and appropriate staff involved in Interdisciplinary Care Teams (ICTs) and the care of PrimeWest Health members annually complete Model of Care (MOC) training and review the PrimeWest Health MOCs.
  5. Cultural Competency Training.  PrimeWest Health is required by the Minnesota Department of Human Services (DHS) to indicate in provider directories whether a provider has completed cultural competence training. In addition, PrimeWest Health requires providers to annually complete cultural competency training in order to participate in our network
  6. Accessibility Standards. Organizations must annually report information on the accessibility of their facilities based on Americans with Disabilities Act (ADA) guidelines.

Action YOU Must Take

Annually, an authorized representative from your organization must verify your compliance with the requirements listed above. The attestations must be completed via PrimeWest Health’s provider web portal each year by December 31. To complete the attestation, log in to the PrimeWest Health provider web portal, then click Forms & Resources>Provider Compliance Attestation Form.

If you are not yet registered for the provider web portal, please complete the Web Portal Registration Form.

Documentation Requirements

Because you may be asked to produce evidence you comply with the requirements listed above, you must maintain documentation of compliance in accordance with Federal regulations, which is no less than 10 years. The inability to produce this evidence may result in a request for a Corrective Action Plan (CAP) or other contractual remedies.  

If you have any questions or concerns regarding the provider attestation, please call PrimeWest Health’s Provider Contact Center at 1-866-431-0802 (toll free) or email compliancetraining@primewest.org.

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Updated_10/19/2021