HEALTH INTEGRATED COMPLIANCE
Introduction. WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION. We are required by law to maintain the privacy of your PHI and to provide you with notice of our legal duties and privacy practices with respect to your PHI. With some exceptions, we will avoid using or disclosing any more of your health information than is necessary to accomplish the purpose of the use or disclosure.
How We Obtain PHI. As a healthcare company, we engage in routine activities that result in receiving PHI from health care providers - such as physicians and hospitals – from your health plan through subcontracting services.
How We Protect PHI Within Our Organization. Health Integrated protects oral, written and electronic PHI throughout our organization. We do not sell PHI to anyone. We maintain physical, electronic and procedural safeguards in compliance with state and federal standards to guard your PHI. These measures include computer safeguards, secured files and buildings, and restrictions on who may access your personal information. Our policies and procedures address, for example, use of PHI by our employees. In addition, we train all employees about these policies and procedures. Our policies and procedures are evaluated and updated for compliance with applicable laws annually.
COMPLIANCE HOTLINE (EthicsPoint) - 844-484-5952
Reporting. It is very important that any illegal activity, including but not limited to potential or actual fraud, waste or abuse, as well as violations of the Code of Ethics, be brought promptly to the Company's attention via the ANONYMOUS EthicsPoint line.
Suspected violations of these Standards of Conduct may be confidentially reported at https://secure.ethicspoint.com/domain/media/en/gui/13314/index.html or 844-484-5952.
CODE OF CONDUCT
A Message from the Chief Executive Officer
At Health Integrated, we are committed to constant adherence to the highest ethical behavior and unquestionable integrity in all of our financial and business activities. As employees, vendors, or subcontractors of this company, you provide the ethical foundation upon which the success of this company is known.
To further promote our company’s core values of ethical business practices, we have developed a Code of Conduct (the “Code”) to outline our ethical and legal obligations. This program sets forth guidelines of professional conduct and will provide assistance should you have questions or doubts if ethical situations arise. It is not intended as a substitute for legal advice concerning compliance with applicable laws. You may always direct your questions to the Compliance Officer or the Hotline.
The health care industry continues to be a highly competitive environment, and the pressure to perform is intense and relentless. Results are always important, but how we achieve those results is equally important. We must always conduct ourselves with the highest degree of ethical standards. In doing so, we not only protect the rights of all our customers and their members, we also protect our reputation as a leader in medical management services.
The Code is an important tool for preserving our corporate culture and core values. Your knowledge and support of the guidelines outlined in the Code will further advance Health Integrated’s position in the market place. I join with you to continue building upon the foundation that many dedicated employees have created for our great company.
Code of Conduct
The following Code of Conduct applies to all Health Integrated Employees (including officers, permanent and temporary employees), and Associates (including the Board of Directors, consultants, independent contractors and FDRs - first tier, downstream and related entities as defined by CMS).
Building Trust and Credibility
The success of our business is dependent on the trust and confidence we earn from our employees, customers and shareholders. We gain credibility by adhering to our commitments, displaying honesty and integrity and reaching company goals solely through honorable conduct. It is easy to say what we must do, but the proof is in our actions. Ultimately, we will be judged on what we do.
When considering any action, it is wise to ask: will this build trust and credibility for Health Integrated? Will it help create a working environment in which Health Integrated can succeed over the long term? Is the commitment I am making one I can follow through? The only way we will maximize trust and credibility is by answering “yes” to those questions and by working every day to build our trust and credibility.
Respect for the Individual.
We all deserve to work in an environment where we are treated with dignity and respect. Health Integrated is committed to creating such an environment because it brings out the full potential in each of us, which, in turn, contributes directly to our business success. We cannot afford to let anyone’s talents go to waste.
Health Integrated is an equal employment opportunity employer and is committed to providing a workplace that is free of discrimination of all types from abusive, offensive or harassing behavior. Any employee who feels harassed or discriminated against should report the incident to his or her manager or to human resources.
Creating a Culture of Open and Honest Communication
. At Health Integrated, everyone should feel comfortable speaking his or her mind, particularly with respect to ethics concerns. Managers have a responsibility to create an open and supportive environment where employees feel comfortable raising such questions. We all benefit tremendously when employees exercise their power to prevent mistakes or wrongdoing by asking the right questions at the right times.
Health Integrated will investigate all reported instances of questionable or unethical behavior. In every instance where improper behavior is found to have occurred, the company will take appropriate action. We will not tolerate retaliation against employees who raise genuine ethics concerns in good faith.
For your information, Health Integrated’s Silent Whistle Reporting Policy, CC-07, is available through Health Integrated’s Intranet portal. Additionally, you should feel free to contact any supervisor or other member of management to request that the policy be provided to you.
Setting Tone at the Top.
Management has the added responsibility for demonstrating, through their actions, the importance of this Code. In any business, ethical behavior does not simply happen; it is the product of clear and direct communication of behavioral expectations, modeled from the top and demonstrated by example. Again, ultimately, our actions are what matters.
To make our Code work, managers must be responsible for promptly addressing ethical questions or concerns raised by employees and for taking the appropriate steps to deal with such issues. Managers should not consider employees’ ethics concerns as threats or challenges to their authority, but rather as another encouraged form of business communication. At Health Integrated, we want the ethics dialogue to become a natural part of daily work.
Upholding the Law.
Health Integrated’s commitment to integrity begins with complying with laws, rules and regulations where we do business. Further, each of us must understand the company policies, laws, rules and regulations that apply to our specific roles. If we are unsure of whether a contemplated action is permitted by law or Health Integrated policy, we should seek the advice from the resource expert. We are responsible for preventing violations of law and for speaking up if we see possible violations.
We are dedicated to ethical, fair and vigorous competition. We will sell Health Integrated products and services based on their merit, superior quality, functionality and competitive pricing. We will make independent pricing and marketing decisions and will not improperly cooperate or coordinate our activities with our competitors. We will not offer or solicit improper payments or gratuities in connection with the purchase of goods or services for Health Integrated or the sales of its products or services, nor will we engage or assist in unlawful boycotts of particular customers.
It is important that we respect the property rights of others. We will not acquire or seek to acquire improper means of a competitor’s trade secrets or other proprietary or confidential information. We will not engage in unauthorized use, copying, distribution or alteration of software or other intellectual property.
We will not selectively disclose (whether in one-on-one or small discussions, meetings, presentations, proposals or otherwise) any material nonpublic information with respect to Health Integrated, its securities, business operations, plans, financial condition, results of operations or any development plan. We should be particularly vigilant when making presentations or proposals to customers to ensure that our presentations do not contain material nonpublic information.
Health and Safety.
Health Integrated is dedicated to maintaining a healthy environment. A safety manual has been designed to educate you on safety in the workplace. If you do not have a copy of this manual, please see your HR department.
Avoiding Conflicts of Interest
Conflicts of Interest. We must avoid any relationship or activity that might impair, or even appear to impair, our ability to make objective and fair decisions when performing our jobs. At times, we may be faced with situations where the business actions we take on behalf of Health Integrated may conflict with our own personal or family interests because of the course of action that is best for us personally may not also be the best course of action for Health Integrated. We owe a duty to Health Integrated to advance its legitimate interests when the opportunity to do so arises. We must never use Health Integrated property or information for personal gain or personally take for ourselves any opportunity that is discovered through our position with Health Integrated.
Here are some other ways in which conflicts of interest could arise:
1. Being employed (you or a close family member) by, or acting as a consultant to, a competitor or potential competitor, supplier or contractor, regardless of the nature of the employment, while you are employed with Health Integrated.
2. Hiring or supervising family members or closely related persons.
3. Serving as a board member for an outside commercial company or organization.
4. Owning or having a substantial interest in a competitor, supplier or contractor.
5. Having a personal interest, financial interest or potential gain in any Health Integrated transaction.
6. Placing company business with a firm owned or controlled by a Health Integrated employee or his
or her family.
7. Accepting gifts, discounts, favors or services from a customer/potential customer, competitor or supplier, unless equally available to all Health Integrated employees.
Determining whether a conflict of interest exists is not always easy to do. Employees with a conflict of interest question should seek advice from management. Before engaging in any activity, transaction or relationship that might give rise to a conflict of interest, employees must seek review from their managers or the HR department.
Gifts, Gratuities and Business Courtesies. Health Integrated is committed to competing solely on a merit of our products and services. We should avoid any actions that create a perception that favorable treatment of outside entities by Health Integrated was sought, received or given in exchange for personal business courtesies. Business courtesies include gifts, gratuities, meals, refreshments, entertainment or other benefits from persons or companies with whom Health Integrated does or may do business. We will neither give nor accept business courtesies that constitute, or could reasonably be perceived as constituting, unfair business inducements that would violate law, regulation or polices of Health Integrated or customers, or would cause embarrassment or reflect negatively on Health Integrated’s reputation.
Accepting Business Courtesies. Most business courtesies offered to us during our employment are offered because of our positions at Health Integrated. We should not feel any entitlement to accept and keep a business courtesy. Although we may not use our position at Health Integrated to obtain business courtesies, and we must never ask for them, we may accept unsolicited business courtesies that promote successful working relationships and good will with the firms that Health Integrated maintains or may establish a business relationship with.
Employees who award contracts or who can influence the allocation of business, who create specifications that result in the placement of business or who participate in negotiation of contracts must be particularly careful to avoid actions that create the appearance of favoritism or that may adversely affect the company’s reputation for impartiality and fair dealing. The prudent course is to refuse a courtesy from a supplier when Health Integrated is involved in choosing or reconfirming a supplier or under circumstances that would create an impression that offering courtesies is the way to obtain Health Integrated business.
Meals, Refreshments and Entertainment. We may accept occasional meals, refreshments, entertainment and similar business courtesies that are shared with the person who has offered to pay for the meal or entertainment, provided that:
• They are not inappropriately lavish or excessive
• The courtesies are not frequent and do not reflect a pattern of frequent acceptance of courtesies from the same person or entity
• The courtesy does not create the appearance of an attempt to influence business decisions, such as accepting courtesies or entertainment from a supplier whose contract is expiring in the near future
• The employee accepting the business courtesy would not feel uncomfortable discussing the courtesy with his or her manager or co-worker or having the courtesies known by the public.
Gifts. Employees may accept unsolicited gifts, other than money, that conform to the reasonable ethical practices of the marketplace, including:
• Flowers, fruit baskets and other modest presents that commemorate a special occasion
• Gifts of nominal value, such as calendars, pens, mugs, caps and t-shirts (or other novelty, advertising or promotional items).
Generally, employees may not accept compensation, honoraria or money of any amount from entities with whom Health Integrated does or may do business. Tangible gifts (including tickets to a sporting or entertainment event) that have a market value greater than $100 may not be accepted unless approval is obtained from management.
Additional rules and policies governing business courtesies in connection with federal officials and entities benefiting from government contracts can be found in Health Integrated’s Bribery and Gratuities Policy, CC-03, and Anti-kickback Policy, CC-02, available through Health Integrated’s Intranet portal. The more rules in such policies are controlling in such circumstances.
Offering Business Courtesies. Any employee who offers a business courtesy must assure that it cannot reasonably be interpreted as an attempt to gain an unfair business advantage or otherwise reflect negatively upon Health Integrated. An employee may never use personal funds or resources to do something that cannot be done with Health Integrated resources. Accounting for business courtesies must be done in accordance with approved company procedures.
Other than to our government customers, for whom special rules apply, we may provide nonmonetary gifts (i.e., company logo apparel or similar promotional items) to our customers. Further, management may approve other courtesies, including meals, refreshments or entertainment of reasonable value provided that:
• The practice does not violate any law or regulation or the standards of conduct of the recipient’s organization
• The business courtesy is consistent with industry practice, is infrequent in nature and is not lavish
• The business courtesy is properly reflected on the books and records of Health Integrated.
Additional Policies. Additional rules and policies governing gifts and business courtesies in connection with federal officials and entities benefiting from government contracts can be found in Health Integrated’s Bribery and Gratuities Policy, CC-03, and Anti-kickback Policy, CC-02, available through Health Integrated’s Intranet portal. The more rules in such policies are controlling in such circumstances.
Setting Metrics and Reporting Results Accurately
Accurate Public Disclosures. We will make certain that all disclosures made in financial reports and public documents are full, fair, accurate, timely and understandable. This obligation applies to all employees, including all financial executives, with any responsibility for the preparation for such reports, including drafting, reviewing and signing or certifying the information contained therein. No business goal of any kind is ever an excuse for misrepresenting facts or falsifying records.
Employees should inform Executive Management and the HR department if they learn that information in any filing or public communication was untrue or misleading at the time it was made or if subsequent information would affect a similar future filing or public communication.
Corporate Recordkeeping. We create, retain and dispose of our company records as part of our normal course of business in compliance with all Health Integrated policies and guidelines, as well as all regulatory and legal requirements. All corporate records must be true, accurate and complete, and company data must be promptly and accurately entered in our books in accordance with Health Integrated’s and other applicable accounting principles. We must not improperly influence, manipulate or mislead any unauthorized audit, nor interfere with any auditor engaged to perform an internal independent audit of Health Integrated books, records, processes or internal controls.
Promoting Substance Over Form. At times, we are all faced with decisions we would rather not have to make and issues we would prefer to avoid. Sometimes, we hope that if we avoid confronting a problem, it will simply go away. At Health Integrated, we must have the courage to tackle the tough decisions and make difficult choices; secure in the knowledge that Health Integrated is committed to doing the right thing. At times, this will mean doing more than simply what the law requires. Merely because we can pursue a course of action does not mean we should do so.
Although Health Integrated’s guiding principles cannot address every issue or provide answers to every dilemma, they can define the spirit in which we intend to do business and should guide us in our daily conduct.
Accountability. Each of us is responsible for knowing and adhering to the values and standards set forth in this Code and for raising questions if we are uncertain about company policy. If we are concerned whether the standards are being met or are aware of violations of the Code, we must contact the HR department. Health Integrated takes seriously the standards set forth in the Code, and violations are cause for disciplinary action up to and including termination of employment.
Confidential and Proprietary Information.
Integral to Health Integrated’s business success is our protection of confidential company information, as well as nonpublic information entrusted to us by employees, customers and other business partners. Confidential and proprietary information includes such things as pricing and financial data, customer names/addresses or nonpublic information about other companies, including current or potential supplier and vendors. We will not disclose confidential and nonpublic information without a valid business purpose and proper authorization.
Use of Company Resources.
Company resources, including time, material, equipment and information, are provided for company business use. Nonetheless, occasional personal use is permissible if it does not affect job performance or cause a disruption to the workplace.
Employees and those who represent Health Integrated are trusted to behave responsibly and use good judgment to conserve company resources. Managers are responsible for the resources assigned to their departments and are empowered to resolve issues concerning their proper use.
Generally, we will not use company equipment such as computers, copiers and fax machines in the conduct of an outside business or in support of any religious, political or other outside daily activity, except for company-requested support to nonprofit organizations. We will not solicit contributions nor distribute non-work related materials during work hours.
In order to protect the interests of the Health Integrated network and our fellow employees, Health Integrated reserves the right to monitor or review all data and information contained on an employee’s company-issued computer or electronic device, the use of the Internet or Health Integrated’s Intranet. We will not tolerate the use of company resources to create, access, store, print, solicit or send any materials that are harassing, threatening, abusive, sexually explicit or otherwise offensive or inappropriate.
Questions about the proper use of company resources should be directed to your manager.
Health Integrated is a high-profile company in our community, and from time to time, employees may be approached by reporters and other members of the media. To ensure that we speak with one voice and provide accurate information about the company, we should direct all media inquiries to management. No one may issue a press release without first consulting with the Marketing department.
Doing the Right Thing
Identification of Issues. Several key questions can help identify situations that may be unethical, inappropriate or illegal. Ask yourself:
• Does what I am doing comply with the Health Integrated guiding principles, Code of Conduct and company policies?
• Have I been asked to misrepresent information or deviate from normal procedure?
• Would I feel comfortable describing my decision at a staff meeting?
• How would it look if it made the headlines?
• Am I being loyal to my family, my company and myself?
• What would I tell my child to do?
Questions. When you have any questions regarding the appropriate course of conduct or any company policy related to our operations, please feel free to contact your manager or supervisor or human resources.
Reporting Violations. It is very important that any illegal activity, including but not limited to potential or actual fraud, waste and abuse as well as violations of the Code, be promptly brought to the Company's attention. Suspected violations of these Standards of Conduct may be reported at https://secure.ethicspoint.com/domain/media/en/gui/13314/index.html or 844.484.5952.