Our commitment to compliance is supported by our confidential compliance hotline and website, which are completely anonymous and accessible 24 hours a day, 7 days a week, 365 days a year. We encourage employees, members, FDRs (First Tier, Downstream, and Related Entities), providers, and vendors to report suspected cases of fraud, waste, abuse, or other violations of company policy in whatever manner they feel most comfortable. We have also established company-wide policies to promote a compliant workplace, such as non-retaliation, internal investigation, self-reporting, and more. For more information, please read our Code of Conduct.

Healthfirst’s commitment to compliance includes ensuring that our First Tier, Downstream, and Related Entities (FDRs) and Affiliates are in compliance with applicable state and federal regulations. Healthfirst contracts with FDRs and Affiliates to provide administrative or healthcare services to our enrollees; we are ultimately responsible for fulfilling the terms and conditions of our contract with the Center for Medicare & Medicaid Services (CMS) and meeting the Medicare and Medicaid program requirements. Therefore, Healthfirst has developed a process to validate that each contracted entity has met the requirements.

Please visit our website at HealthfirstFDR.org to review the FDR and Affiliate Compliance Guide, which includes the FDR and Affiliate compliance requirements, and to complete the FDR and Affiliate Compliance Attestation.