Inland Empire Health Plan (IEHP) is committed to conducting its health plan operations in compliance with ethical standards, contractual obligations under State and Federal programs, laws, and regulations applicable to Medi-Cal and IEHP DualChoice. This commitment extends to our business associates and delegated entities that support IEHP’s mission to improve the delivery of quality, accessible, and wellness based healthcare services for our community.
Our Compliance Program is designed to:
- Ensure we comply with applicable laws, rules, and regulations
- Reduce or eliminate Fraud, Waste, and Abuse (FWA)
- Prevent, detect, and correct non-compliance
- Reinforce our commitment to culture of compliance for which we strive
- Establish and implement our shared commitment to honesty, integrity, transparency, and accountability
What is an FDR?
A First Tier, Downstream or Related Entity (FDR) is a delegated entity subcontracted on behalf of IEHP to provide health plan related services.
FDRs are required to follow IEHP’s policies and procedures, Code of Business Conduct and Ethics, and other contractual requirements.
Compliance Program Requirements Manual/Vendor First Tier Downstream and Related Entities (FDRs)
IEHP Compliance Program Description
IEHP Code of Business Conduct and Ethics
Non Retaliation Policy
Delegation Oversight Provider Manual PnP (Coming Soon)
Document Retention (Coming Soon)
FDR Compliance Program Attestation
CMS Compliance, FWA, and HIPAA training material
ICE FWA Training
ICE General Compliance Training
Code of Business Conduct and Ethics
Inland Empire Health Plan (IEHP) expects Team Members and business entities doing business with IEHP to conduct business activities in an ethical and professional manner that promotes public trust and confidence in the integrity of IEHP. The Code provides guidance about the compliance culture at IEHP and the role that each Team Member, including Senior Management, Chief Officers, the Governing Board, and our business partners, play in building and preserving that culture.
Compliance, Fraud, Waste, and Abuse (FWA), and Privacy Program Training
The IEHP Compliance, FWA, and Privacy Training Program focuses on to the elements of an effective Compliance Program, conduct & ethics, and the Fraud, Waste and Abuse and Privacy Programs.
IEHP requires delegated entities to provide Compliance Training to their employees, Providers, downstream entities, Board of Directors, and Contractors within 90 days of hire/start date.
IEHP is committed to a culture of compliance, ethics, and integrity, the goal of Compliance Training is to provide all associated parties the ability to demonstrate awareness of IEHP’s requirements, including regulations and policies & procedures associated with Compliance as it relates to daily work.
If you have questions or additional suggestions, please e-mail The IEHP Compliance Department at firstname.lastname@example.org
General Compliance Training
IEHP has the following resources available for reporting fraud, waste or abuse, Privacy issues, and other compliance issues: