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HCP Compliance Program

Our Commitment to Compliance

At HCP, we demonstrate our commitment to integrity and continuous compliance with legal and regulatory requirements through our business operations. We strive to further demonstrate this commitment by providing guiding principles for ethical conduct to our provider network, first-tier, downstream or related entities (FDRs), as well as our Workforce, to facilitate the delivery of the highest quality care to your patients.

Code of Conduct & Corporate Compliance Program

Our Code of Conduct and Corporate Compliance Program collectively outline expected standards of conduct for our Workforce, providers, and FDR partners. They also provide the framework for compliance with state and federal laws established to prevent, detect and correct healthcare fraud, waste, and abuse and other non-compliant behavior.

Conflict of Interest and the Acceptance of Gifts Policy

Our Conflict of Interest and the Acceptance of Gifts Policy provides guidance for the acceptance of gifts from vendors and patients and for recognizing and avoiding situations that may present a conflict of interest (COI).  All HCP providers are expected to read, understand and comply with this policy. As a HCP Provider you are also required to complete the COI Disclosure Form provided in your re-credentialing package during the process or whenever a potential COI may arise.

Training & Education

HCP ensures that our providers and FDRs meet the Centers for Medicare and Medicaid Services (CMS) regulations by providing access to required general compliance and/or Fraud, Waste and Abuse (FWA) Training, in accordance with 42 CFR § 422.503 and 42 CFR § 422.504. Other training modules are required in accordance with the Health Insurance Portability and Accountability Act (HIPAA) privacy and security and other compliance related regulations.

Annual HCP Direct Provider Training Modules (Required)*

Instructions

  1. You may complete the following courses online by clicking in the course link below, or
  2. You may complete your own organization’s comparable training and select this option in the Provider & FDR Compliance Attestation.

Optional Courses

Provider & FDR Compliance Attestation (Required)

You must submit the online “Attestation of Compliance” following completion of the required training upon credentialing or contracting and annually thereafter. HCP will notify you each year when your annual Attestation is due. You will be prompted to affirm your compliance with HCP’s and CMS’ training requirements and Federal and State Medicaid exclusion screening requirements.

To access and complete, use this form: 

Online Attestation Form

HIPAA Security & Privacy

Compliance with the provisions of the Health Insurance Portability and Accountability Act (HIPAA) is one of our top priorities. We are dedicated to maintaining the security and privacy of our members’ information. We provide training to our Workforce, provider network and FDRs in accordance with our obligations under the HIPAA Privacy Rule and HIPAA Security Rule and to ensure that proper access , use and/or disclosure of protected health information.

Reporting Fraud, Waste and Abuse

HCP has established a confidential hotline that enables employees, providers, patients, vendors and other parties to report illegal conduct, compliance concerns, privacy issues and other activity that might be a violation of HCP’s policies and healthcare related regulations.

Compliance Hotline

Call: (888) 475-8376 (Available 24/7 and in multiple languages)

Online: Click here to submit a report

You may remain anonymous when submitting reports by phone and online.

Whistleblower & Non-Retaliation Policy

HCP’s Whistleblower & Non-Retaliation Policy prohibits intimidation or retaliation against anyone who reports a compliance concern in good faith.

Whistleblower & Non-retaliation Policy