Compliance policy

Questions? Contact us.

The VNS Health system including all of its provider and health plans (collectively, “VNS Health”) is proud of its long tradition of ethical and responsible conduct. VNS Health is committed not only to providing our patients and members with the highest quality services but also to providing those services pursuant to the highest ethical, business, and legal standards.

To that end, VNS Health has implemented a comprehensive Compliance Program to ensure that legal and ethical conduct is an integral part of our organization’s culture, mission, and operations.

Information about the VNS Health Health Plans Compliance Program is also available.

VNS Health’s Code of Conduct is our statement of ethical and compliance principles that guide our daily operations.

The Code of Conduct applies to all provider and health plans in the VNS Health system. All directors, officers, employees, contractors, volunteers, interns, agents, and others associated with the provider and health plans in the VNS Health system are required to comply with the Code of Conduct.

The Code of Conduct requires VNS Health’s Personnel to report any action(s) that may be unlawful, inappropriate, or in violation of our Code of Conduct, policies and procedures, or applicable laws, rules, and regulations without fear of intimidation or retaliation.

VNS Health has adopted and implemented numerous compliance policies and procedures that further support our commitment to compliance, as embodied in the Compliance Program and Code of Conduct, and ensure that the Program is operating effectively and with integrity. These policies and procedures include, without limitation:

Notice of Non-Discrimination

Policy on Non-Retaliation and Non-Intimidation

VNSNY CHOICE Health Plans Fraud, Waste, and Abuse Detection Manual

The Detection and Prevention of Fraud, Waste and Abuse and Applicable Federal and State Laws (DRA Policy)

Sanction Checks

Anonymous Hotlines and Online Reporting Tool

VNS Health Hotline: 1-212-290-4773
VNSNY CHOICE Hotline: (888) 634-1558
VNS Health Online Reporting Tool: www.vnshealth.ethicspoint.com

Through our Hotlines and Online Reporting Tool, individuals can report a concern or seek guidance about compliance questions:

• 24 hours, 7 days a week

• Anonymously, if you choose

• Without worry of retaliation or intimidation

• Compliance Leadership

Contact Compliance Leadership:

Marianna (Annie) Miyazaki-Grant
SVP, Chief Compliance & Privacy Officer
Phone: 1-212-609-7470
Email: [email protected]

or

Doug Goggin-Callahan
VP, Compliance & Regulatory Affairs
Phone: 1-347-804-8601
Email: [email protected]

Individuals can also send materials to the Compliance Department by fax or mail:

VNS Health
Attn: Compliance Department
220 East 42nd Street, 6th Floor
New York, NY 10017
1-646-459-7729 (fax)
1-646-459-7730 (fax)

VNS Health Health Plans has established a comprehensive Fraud, Waste, and Abuse Prevention Program to prevent, detect, and correct fraud, waste, and abuse by employees, members, providers, agents, contractors and FDRs of VNS Health Health Plans. For more information, please see the Fraud, Waste and Abuse Detection and Prevention page.

CMS Compliance Program Policy and Guidance – Information on Centers for Medicare and Medicaid Services (CMS) Compliance Program requirements and links to compliance training.

NYS OMIG Compliance – New York State Office of the Medicaid Inspector (NYS OMIG) General Bureau of Compliance page, with links to the Compliance Library.

HHS Office of Civil Rights – HIPAA – U.S. Department of Health and Human Service Office of Civil Rights website offers information on health information privacy and security.

New York State Department of Health – Information about New York State Department of Health, as well as Model Contracts for VNSNY CHOICE’s Medicaid Managed Long Term Care (MLTC) and Medicaid Managed Care Special Needs Plan (SNP) can be accessed here.

Last updated 7/1/2020