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
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)
