To access the Compliance Reporting Program Hotline by phone, dial toll free within the United States jurisdiction. 1.877.627.0004

Compliance

(Please choose your category)

Conflict of Interest Non Disclosure of Actual or Potential Conflict of Interest - The reporter is aware that an employee has an actual or potential conflict of interest as result of his/her employment and its relationship with another person or entity, whether business or personal. For example, an employee provides professional services to a provider in the network. Gifts and Donations Improper Acceptance of Gifts or Donations; Improper Political Contributions. Inaccurate Reporting Unauthorized Modification of Data to be Reported or Data Created for Internal Use - The reporter is aware that an employee modified data to be reported or transmitted within or outside our health care plan without notification or authorization from the employee direct supervisors. For example, an employee changed the number of Medicare Advantage (MA) sales of the monthly sales report. Misuse of Company Resources Unauthorized Use of Company Facilities and Equipment - The reporter is aware that an employee is using the company’s property, whether equipment or facilities, for personal gain. For example, utilizing copy machines for personal business purposes not related to our businesses. Violations of CMS (Medicare/Medicaid), Health State Department and/or Department of Insurance applicable Laws and Regulations Perceived or Confirmed Violation of Applicable Federal and State Laws and Regulations - The reporter is aware that a situation has arisen in which the health plan as an entity or a health plan employee or representative has violated a specific law or regulation applicable to the health plan. For example, the reporter has actual knowledge that the health plan sales agent does not have the required insurance license by the Department of Insurance. Violations of Communications and Marketing Guidelines False Information on Enrollment Application; False information Provided by the health plan Agents/Representatives; Unauthorized Use and/or Distribution of Marketing Materials; Unsolicited Contact by a health plan Agents/Representatives. Violations of Policies and Procedures Non Compliance with Established Timeframes; Policy and/or Procedure not in Compliance with Federal and State Laws and Regulations; Unauthorized Use of our applications. Other Other Compliance issues Back to Main Page
ATTENTION! This webpage is hosted on EthicsPoint's secure servers and is not part of the MCS/GlobalHealth website or intranet.