HNS Policy
I. Introduction
HNS’ mission is to make health care more accessible, more effective and more affordable. Committed to a more efficient health care delivery system, HNS’s programs, policies and best practices seek to ensure the delivery of quality, cost-effective healthcare.
As a clinically integrated IPA, HNS is organized in a manner to create efficiencies for contracted managed care plans, their members or beneficiaries, and its contracted health care practitioners and to provide various administrative and support services to both physician participants and the health plans which contract with HNS.
HNS has developed best practices which establish HNS Compliance Policies for contracted health care professionals. These policies establish HNS’ performance expectations for all contracted health care professionals.
These policies are intended to:
- Promote awareness among contracted health care professionals of our legal environment;
- Promote compliance with laws relevant to the health care industry, including but not limited to Fraud, Waste and Abuse laws, HIPAA, and the Affordable Care Act;
- Help to prevent accidental and intentional non-compliance to those laws;
- Promote a more efficient health care system.
These policies are consistent with guidance issued by the Office of Inspector General (OIG), industry standards and federal and state laws.
HNS reserves the right to review and modify its Compliance Policies at any time and will provide timely notification to contracted health care professionals of any material changes.
Failure to Comply
HNS takes our compliance responsibilities seriously and failure to comply with HNS Compliance Policies will subject contracted health care professionals to disciplinary action by HNS, up to and including termination of their Practitioner’s Participation Agreement. Additionally, health care professionals who violate laws and regulations risk individual criminal prosecution and penalties, civil actions for damages and penalties, and exclusion from federal and private health care programs.
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Compliance Policies for Contracted Health Care Professionals