Code of Conduct, Reporting Issues, Annual Training
Posted on December 5, 2016
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice.
If you have any questions about the information in this notice, please contact Health New England Provider Relations at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.
Health New England Code of Conduct:
It is Health New England’s policy to conduct its business in compliance with all applicable federal and state laws and regulations and to assure that Health New England operates in a manner consistent with the letter and the spirit of the laws. Health New England expects its employees, management, governing body members and first tier, downstream and related entities (FDRs) or “Covered Individuals” to adhere to this Code of Conduct when conducting business on behalf of Health New England and its subsidiaries. Read our Code of Conduct at healthnewengland.org/Code-of-Conduct. Refer to Section E for a definition of what constitutes a Covered Individual.
Reporting Concerns:
All Covered Individuals are required to promptly report potential compliance, or fraud, waste and abuse (FWA) issues of which they have knowledge or a good faith belief. Report in one of the following ways:
a) Report to Health New England Compliance: compliancedepartment@hne.com.
b) Call the Health New England Compliance hotline toll-free at (800) 453-3959, 24 hours, seven days a week (reports can be made anonymously).
c) Potential fraud may also be reported directly to the Department of Health and Human Services (HHS) Office of Inspector General (OIG) Hotline:
- Phone: (800) HHS-TIPS or (800) 447-8477 TTY: (800) 377-4950
- Fax: (800) 223-8164
- Mail:
US Department of Health and Human Services
Office of Inspector General
Attn: OIG Hotline Operations
PO Box 23489
Washington, DC 20026
Annual Training Requirement:
FDRs who have not met the FWA certification requirements through enrollment into the Medicare program or accreditation as a DMEPOS must annually certify that they have taken the CMS-developed or comparable training. Review acceptable methods for completing compliance training requirements and audit process: https://www.cms.gov/Medicare/Compliance-and-Audits/Part-C-and-Part-D-Compliance-and-Audits/Downloads/2016_Compliance_and_-FWA_Training_Requirement_Update.pdf
General compliance and FWA training is available on the CMS Medicare Learning Network (MLN). Go to the MLN Provider Compliance page for the CMS-developed training: https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/providercompliance.html
