What Compliance Concerns Should be Reported?

  • Violation of laws, rules, or regulations such as the Federal Civil False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral (Stark) Law, the Health Insurance Portability and Accountability Act (HIPAA), or the Health Information Technology for Economic and Clinical Health Act (HITECH)
  • Violation of the Prominence Health Plan Code of Conduct
  • Violation of Prominence Health Plan or UHS policies and procedures
  • Fraud – Intentional financial or accounting misconduct, questionable auditing practices, bribery or falsification of company records
  • Waste – Poor/inefficient practices that result in unnecessary costs to the health plan
  • Abuse – Actions inconsistent with accepted medical or business practices that result in unwarranted payments or costs to the health plan

How Should Compliance Concerns be Reported?

If you are aware of potential or actual non-compliance, you are required to report these concerns to the Compliance Office. You may use the Compliance Reporting link at uhs.alertline.com to submit a compliance concern or call the Compliance Hotline at 1-800-852-3449 (available 24/7/365).

Reports may be made anonymously and will be handled confidentially.

Prominence Health Plan has a ZERO tolerance policy for retaliation, retribution or harassment against employees for reports of a suspected violation made in good faith.

Additional Compliance Reporting Options

Contact the Prominence Health Plan Chief Compliance Officer, Philip Ramirez, at 1-775-984-9348 or [email protected] or any member of the Compliance team. Other options include:

Medicare Fraud Hotline
1-800-MEDICARE (1-800-633-4227)

Medicare Part C & D Fraud Hotline
1-877-7SAFER (1-877-772-3379)

Office for Civil Rights
1-800-368-1019

OIG Fraud Hotline
1-800-HHS-TIPS (1-800-447-8477)

Compliance Reporting

What Compliance Concerns Should be Reported?

  • Violation of laws, rules, or regulations such as the Federal Civil False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral (Stark) Law, the Health Insurance Portability and Accountability Act (HIPAA), or the Health Information Technology for Economic and Clinical Health Act (HITECH)
  • Violation of the Prominence Health Plan Code of Conduct
  • Violation of Prominence Health Plan or UHS policies and procedures
  • Fraud – Intentional financial or accounting misconduct, questionable auditing practices, bribery or falsification of company records
  • Waste – Poor/inefficient practices that result in unnecessary costs to the health plan
  • Abuse – Actions inconsistent with accepted medical or business practices that result in unwarranted payments or costs to the health plan

How Should Compliance Concerns be Reported?

If you are aware of potential or actual non-compliance, you are required to report these concerns to the Compliance Office. You may use the Compliance Reporting link at uhs.alertline.com to submit a compliance concern or call the Compliance Hotline at 1-800-852-3449 (available 24/7/365).

Reports may be made anonymously and will be handled confidentially.

Prominence Health Plan has a ZERO tolerance policy for retaliation, retribution or harassment against employees for reports of a suspected violation made in good faith.

Additional Compliance Reporting Options

Contact the Prominence Health Plan Chief Compliance Officer, Philip Ramirez, at 1-775-984-9348 or [email protected] or any member of the Compliance team. Other options include:

Medicare Fraud Hotline
1-800-MEDICARE (1-800-633-4227)

Medicare Part C & D Fraud Hotline
1-877-7SAFER (1-877-772-3379)

Office for Civil Rights
1-800-368-1019

OIG Fraud Hotline
1-800-HHS-TIPS (1-800-447-8477)