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Medicare attestation form 2026

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The document is a training attestation form for Coventry Health Care, confirming the completion of Fraud, Waste, and Abuse training as required by the Centers for Medicare & Medicaid Services (CMS) for Medicare Advantage plans. It includes a section for personal information and acknowledges that CMS may request further documentation.

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Click ‘Get Form’ to open the Medicare Attestation Form in our editor.
Begin by entering the date you completed the Coventry Health Care Fraud, Waste, and Abuse training in the designated field (Month/Day/Year).
Fill in your name in the format of Last, First in the Name section.
Provide your complete address including Street, City, State, and Zip Code.
Enter your phone number in the Phone Number field for contact purposes.
Lastly, input either your NPI Number or License Number as required.

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