Compliance

Our organization has a comprehensive, values-based Compliance Program, which exists to help all BSWH trustees, officers, and employees follow the applicable policies, procedures, laws and regulations. The Code of Conduct is the foundation of the Compliance Program because it sets the tone for our personal and business behavior. Because the Code of Conduct rests on our Mission and Values, it is an integral part of our daily activities. Our commitment is to uphold the highest ethical standards in regards to Federal and State regulations as well as our own internal policies and procedures on quality, member’s rights, confidentiality, and more.

Report Fraud, Waste and Abuse — Healthcare fraud costs Americans billions of dollars each year. Our organization is committed to detecting, correcting and preventing Fraud, Waste and Abuse (FWA). Visit the link to learn more about our FWA policy and how to report FWA or any other Compliance concerns.

HIPAA Official Rules, Privacy Notices & Forms —Our organization recognizes the importance of protecting your personal information. Privacy standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the US health care system. The information collected during your visit is limited and only used to help us support and enhance our relationship with you. Your information may also be used to improve our services, your healthcare, and your online experience. Visit the link to learn more about our Privacy Policy and how to report Privacy or any other Compliance concerns.

Delegated entities (Delegates) otherwise known as Vendors, Subcontractors, and First Tier, Downstream, and Related Entities (FDRs) — Scott and White Health Plan (SWHP) and its wholly owned subsidiaries maintain a process to monitor delegated functions and responsibilities so that we are able to validate compliance with Federal and State laws, as well as contractual regulations. Guidelines indicate that vendors, subcontractors, and delegated entities (delegates), including First Tier, Downstream, and Related Entities (FDRs) who partner with us should follow the same compliance guidelines as SWHP while working on SWHP business.

Compliance Concerns — Our organization is committed to the highest standards of business and professional ethics and integrity. The Code of Conduct is our foundation to that commitment. We encourage to report situations that could potentially lead to actions that might conflict with the Code of Conduct without fear of retaliation. We have hired an outside company to take Compliance HelpLine calls and online reports. The operators of the Compliance HelpLine are trained to assist you in reporting questions and concerns. Calls and reports to the HelpLine will not be traced or recorded.