Compliance Training

Learn more about our Compliance Program. Here you can also access our compliance training materials for first tier, downstream and related entities and our Standards of Conduct.

Provider Education

As required by CMS, all associates of Easy Choice Health Plan of New York, its’ contractors, subcontractors and first tier, downstream and related entities (also referred to as FDRs) who are delegated core functions under the Plan’s Part C and D contracts with CMS must complete compliance training.  You may use your own compliance training or use the training materials provided here. Within 90 days of contracting and annually thereafter, FDRs are required to attest that they have reviewed the training materials on this website.  Please complete the training attestation and submit it to the Provider Relations Department via fax at 646-929-9216.  For questions, please contact Provider Relations at 1-888-300-9320.

Easy Choice Health Plan of New York distributes its Standards of Conduct to its FDRs, who are delegated core functions under the Plan's Part C and D contracts with CMS.  For questions please contact 888.300.9320 Option #4.  As an FDR, you are also required to distribute your own Standards of Conduct and compliance policies to your employees within 90 days of their hire date and annually thereafter.  If you do not have your own Standards of Conduct and wish to adopt ours, you may do so.  Our Standards of Conduct are located at the link below.  If you would like to adopt our compliance policies, these can be provided upon request. For questions or more information, please contact Provider Relations at 1-888-300-9320, Option #4.

Compliance - Provider/Vendors Training Management System
View and download our FWA Training document; Compliance Training; Conflict of Interest Policy; Standards of Conduct document; and complete the FDR Attestation for mandatory CMS compliance.

HIPAA

Compliance with our state and federal partners is essential to providing accurate, timely and comprehensive care for Members. Below is a listing of requirements (not all-inclusive) that Physicians and Providers are required to meet.

Protected Health Information (PHI)

The Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. For a complete description of Physician/Provider requirements, visit the Department of Health& Human Services' website at:

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/index.html

For more information on HIPAA requirements, please visit the regulations and guidance page of Centers for Medicare & Medicaid website at:

 http://www.cms.hhs.gov/home/regsguidance.asp

National Provider Identifier (NPI)

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. An NPI is a unique identification number for covered health care providers.  Easy Choice Health Plan of New York requires the use of NPIs for all claims transactions. For more information about NPI, visit the website for the Centers for Medicaid and Medicare Services at: http://www.cms.hhs.gov/NationalProvIdentStand/

Last Updated: 09/30/2014