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False Claims Employee Education

Section 6032 of the Deficit Reduction Act (DRA) of 2005 requires certain entities to educate employees about false claims.  South Dakota Medicaid is required to provide oversight of this process in accordance with the procedures established in the South Dakota Medicaid State Plan.

Entities must annually attest:

  • The entity has a written policy including detailed information about false claims that is distributed to all employees, contractors, and agents.
  • A written policy regarding false claims is included in the entity’s employee handbook, if the entity has an employee handbook. Entities are not required to write an employee handbook if a handbook does not already exist.

The Center for Medicare and Medicaid Services (CMS) defines an entity as: a governmental agency, organization, unit, corporation, partnership, or other business arrangement whether for-profit or not-for-profit, which receives or makes Medicaid payments totaling at least $5 million annually. An entity may include multiple locations, as well as multiple billing NPIs and tax identification numbers. For further information about the definition of an entity, please consult our frequently asked questions.

To determine if your business or organization meets the definition of an entity, first identify all components of your organization, corporation, partnership or business arrangement. This may include multiple locations, billing NPIs, and FEINs. Then, total all payments from South Dakota Medicaid received in the last federal fiscal year (October 1, 2012 to September 30, 2013). If the total of all payments exceeds $5,000,000 then your business meets the definition of an entity. However, if aggregate payments do not exceed $5,000,000 then you do not meet the definition of an entity and do not need to attest.

Complete the 2014 Attestation Form

South Dakota Medicaid prefers to receive completed forms via email at: MedicaidAttestations@state.sd.us.

Read the South Dakota Medicaid State Plan, Federal Law and Federal Guidance: