ACO Compliance Attestation

UC San Diego Health Accountable Care Network Compliance Form

UC San Diego Health Accountable Care Network is committed to regulatory compliance and the highest standards of business integrity. Our goal is to ensure that all ACO participant providers are trained, accountable, and in full compliance with legal, regulatory and ethical standards. We provide compliance training and have all ACO participants attest to their compliance annually.

Participant providers of UC San Diego Health Accountable Care Network, an MSSP ACO, are required by CMS regulations to attest to completing appropriate education and training related to the Network’s compliance program requirements and how to identify, correct and prevent potential fraud, waste and abuse. Please view the compliance training presentation here. This attestation of compliance is made annually for all participant providers. The basis for this requirement comes from 42 CFR parts 422 and 423 of the Medicare Program.

By signing below, I attest that my organization, an MSSP ACO participant in UC San Diego Health Accountable Care Network, Inc. (Network), and all providers billing CMS under my organization’s tax identification number (TIN) for services rendered to Network assigned beneficiaries have read and agree to comply with:

  • (i) All Network policies and procedures and standards;
  • (ii) Prevention of fraud, waste and abuse training requirements in accordance with guidelines set by CMS;
  • (iii) General compliance training requirements in accordance with guidelines set by CMS on an annual basis.

My organization shall:

  • (iv) Conduct regular validation checks to ensure compliance with the State and Federal exclusion lists;
  • (v) Retain attestations, individual training records and training materials for 10 years from the last day of the calendar year for the reporting period.

I am authorized to bind the entity and I attest that the above information is true and correct. I will notify Network representatives of any changes to this information.


​If you have any questions, please contact Network Operations, UC San Diego Health Physician Network, at 858-249-0279 or email physiciannetwork@ucsd.edu.