1. Fraud & Abuse policy and procedures
2. Training program/materials related to Fraud & Abuse
3. Policies & Procedures for implementing a corrective action plan once a Fraud &
Abuse violation has been identified (can refer to both vendor or provider)
4. Description of the reporting path for Compliance/Fraud
5. Investigative reports related to (Name)
6. HIPAA Policy and Procedures
7. HIPAA training materials
8. Process for documenting new employee HIPAA training
9. Policy & Procedures for destruction of PHI
10. Compliance policy and procedures
11. Review of Compliance training program
12. Review of procedures relating to the Ethics Hotline
13. Review of internal audit policy and procedures
14. Internal Audit reports & exception reports
15. Formal report with supporting documentation of all investigations and findings
regarding (Name) business
16. Copies of all External Audit findings by Federal and State regulatory agencies and
Corrective Action Plans
17. Copies of the Code of Conduct
18. Copies of the Conflict of Interest Form
19. Evidence that the Code of Conduct and Conflict of Interest form were provided to
all employees as well as any downstream entities
FINANCE
The following information is needed for the Finance Audit:
1. Policies and Procedures
2. Copy of most recent audited financial statements
3. Certificates of insurance including Liability and Errors of Omission
4. SAE 16 Report (if applicable, formerly SAS 70)
DELIVERABLES
Please use the following address to mail the requested materials:
Name
Title
Health Plan
Address
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