Compliance

Thank you for visiting the Nuvance Health® Corporate Compliance Office (“Compliance”) page.

The Compliance team maintains Nuvance Health’s Corporate Compliance Program (the “Program”). We designed the Program to:

• Detect, deter, and reduce incidents of illegal, unprofessional and unethical conduct, fraud, waste and abuse
• Enhance Nuvance Health’s operations and the quality of healthcare delivery
• Reduce healthcare costs

The purpose of the program

The team uses the Program to establish an organizational culture throughout Nuvance Health that promotes the prevention, detection and resolution of conduct that fails to comply with:

• Applicable Federal and State administrative, civil and criminal law
• Requirements of Federal healthcare programs and private payors
• Nuvance Health’s standards of ethical and business conduct and the policies and procedures that support those standards

The Program covers the following risk areas and more:

• Billings, payments and mandatory reporting of overpayments
• Credentialing
• Medical necessity
• Quality of care
• Privacy and security of patient and employee information (e.g., HIPAA privacy and security)
• Human subject research protections

As part of its mission to implement an effective and comprehensive Program, Compliance operates an internal audit division. This division provides independent, objective assurance and consultative services that add value and improve Nuvance Health’s operations.

The internal activity brings a systematic, disciplined approach to evaluating and improving governance, risk management and control processes.  

Open lines of communication promote compliance

The Program establishes open lines of communication through initiatives including:

• Training and education programs
• Confidential and anonymous helpline
• Internal audit activities
• HIPAA privacy and security program

We use information gathered to provide guidance on the management and operation of all Nuvance Health facilities, units and entities in a legally compliant and ethical manner. Compliance shares its findings with:

• Nuvance Health Board of Directors
• Senior management and administrators
• Physicians, clinicians and allied health professionals
• Support staff and other personnel

Mandatory compliance and reporting

We take pride in carrying out our patient care activities, business functions and community relations in a responsible way, governed by our:

• Reason for being and values
• Nuvance Health Compliance and Ethics Program Charter
• Medicare Part C and D Communication and Training
• Nuvance Health Internal Audit Charter
• Nuvance Health Vendor Code of Conduct
• Nuvance Code of Conduct and Business Ethics

Workforce members, business affiliates and agents (“Covered Individuals”) who violate organizational policies and procedures will be subject to progressive disciplinary action. These actions may include termination of employment, contract or other affiliation with Nuvance Health.

Nuvance Health expects covered Individuals to promptly report to Compliance any known unethical, unprofessional, illegal, improper or unsafe conduct they become aware of.

Confidential and anonymous reporting of compliance issues and concerns

We invite covered Individuals to report compliance issues, concerns and Program violations anonymously and confidentially by:

• Calling the 24-hour Nuvance Health confidential and anonymous Compliance Hotline:
  • (844) YES-WeComply (for covered individuals at legacy Health Quest)
  • (844) 395-9331 (for covered individuals at legacy WCHN)
• Submitting comments online at: nuvancehealth.ethicspoint.com
• Covered Individuals may also confidentially report compliance issues, concerns and Program violations in person, by U.S. mail or interoffice mail, telephone, fax or email.

Anti-retaliation/whistleblower protection

Nuvance Health protects whistleblowers and strictly prohibits retribution, harassment, intimidation or any other form of retaliation. We extend this protection to Covered Individuals or other persons or entities that, in good faith, make a compliance report or complaint or have otherwise participated in the Program. Read the whistleblower protection policy.

Nuvance Health

• Communication Regarding the Deficit Reduction Act of 2005
• Financial Conflicts of Interest in Public Health Service Funded Research Policy
• Policies and Procedures

New York (legacy Health Quest)

• Policies and Procedures

Patient rights and responsibilities

• Connecticut
• New York

Additional resources

• Read our accessibility statement
• Read our website privacy policy