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  • Attestation Regarding Monitoring Of Exclusionary Databases Form

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Attestation Regarding Monitoring of Exclusionary Databases Pursuant to 42 CFR 455. 101 Section 18. 9 c of the MMC/FHP Contract and per the New York State Department of Health Standard Clauses effective March 1 2011 Section B 9 contained in all MVP contracts MVP is required to obtain an attestation from all provider groups and facilities each a Provider confirming that they have a policy requiring that they monitor all employees staff and agents associated with the Provider against the following exclusionary databases on a monthly basis and that they are performing such monitoring OIG Database http //exclusions. oig. hhs. gov/ System for Award Management www. sam*gov MVP will follow applicable regulatory requirements associated with the disclosure of this information up to and including termination of any contracts with Providers found not to be in compliance with this requirement. Provider Name Provider Address Phone Provider Tax ID Yes I hereby attest on behalf of the above-referenced....

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Referenced Related content

Exclusions | Office of Inspector General | U.S...
This webpage provides information about OIG's exclusion authority and activities. OIG has...
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Exclusion Screening | USC Office of Culture...
“Exclusion Lists” include the Office of Inspector General (OIG) List of Excluded...
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city of oakland - Amazon AWS
Jul 18, 2020 — Request for Taxpayer Identification Number and Certification which can be...
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232