Prominence Health Plan Compliance Program Guidelines

Prominence Health Plan is committed to compliance with all applicable federal and state laws, rules and regulations. This commitment is key to all levels of the organization. Our Compliance Program was created to ensure we conduct our business with integrity and in accordance with applicable laws and our policies, as well as to provide a safe environment for raising compliance concerns and questions. The Compliance Committee oversees the Compliance Program and ensures compliance with our Code of Conduct.

Our Compliance Program outlines what we do as an organization to comply with legal and ethical requirements, including the following:

  • Setting standards through written policies, procedures and our Code of Conduct
  • Communicating standards through awareness, education and training programs
  • Providing a process for reporting potential violations of laws, policies or our Code of Conduct
  • Conducting ongoing auditing and monitoring activities
  • Identifying, investigating and responding to potential compliance problems
  • Performing routine background checks to ensure we are not conducting our business with individuals and entities ineligible to participate in federal healthcare programs
  • Enforcing integrity standards and disciplining non-compliant actions
  • Maintaining an organizational structure that supports the furtherance of the Compliance Integrity Program, including establishment of a Compliance Committee and appointment of a Chief Compliance Officer who have an independent reporting relationship with the Board of Directors

Reporting Concerns

Visit our Compliance Reporting page to learn more about how to report a compliance concern >