HCSC Compliance Program
Report Fraud Issues Anonymously – Available 24/7. You can contact us at 1-800-543-0867.
HCSC Takes Compliance Seriously
Health Care Service Corporation (HCSC) and its subsidiaries are founded on the basic principles of good business behavior. Among these principles are a commitment to the highest standard of business ethics and integrity.
This includes strict observance of and compliance with the laws and regulations governing the business operations of HCSC and its majority-owned (greater than 50%) subsidiaries, and in particular, the services that it performs or has delegated to others to perform pursuant to its government programs.
The Compliance Program demonstrates the Company’s commitment to full and comprehensive compliance with all Applicable Laws and regulations, Exchange requirements and contract terms and conditions, including, without limitation, the Company’s obligation under Medicare Advantage [including Dual Eligible Special Needs Plans (D-SNPs)], Medicare Part D, Medicare-Medicaid Plans (MMPs), Medicaid and/or Government Sponsored Children’s Health Insurance Program (herein “CHIP”) contracts, and Individual and Family Markets and Commercial Group health plans (hereinafter collectively referred to as “Government Programs”).
How Does HCSC Maintain Government Programs Compliance?
Any individuals who impact HCSC's government programs are expected to abide by HCSC's Compliance Program, which includes a section specific to Government Programs, the HCSC Code of Ethics and Conduct and Government Programs Compliance Policies. You can review these documents and additional resources here.
(Note: Government Programs section begins on page 39)
Appendices
Appendix A: Code of Ethics and Conduct
Appendix B: Vendor Code of Ethics and Conduct
Appendix C: Code of Ethics and Conduct for Directors
Appendix D: Code of Ethics and Conduct for Subsidiary Directors
Appendix E: HCSC Government Programs and Policies
- Government Programs Compliance Program Overview - Medicare
- Medicare Written Policies, Procedures and Standards of Conduct
- Medicare Effective Training and Education
- Medicare Communication and Reporting Mechanisms
- Medicare Disciplinary Standards
- Medicare System to Identify Medicare Compliance Risks
- Routine Monitoring and Auditing of Medicare Programs
- Medicare Accountability and Oversight of First Tier, Downstream and Related Entities
- Identifying Excluded Individuals and Entities
- Medicare Programs Fraud, Waste and Abuse
- Medicare Auditing by Government Entities
- Medicare Prompt Responses to Compliance Issues and Corrective Actions
- Medicare Record Retention Policy
- Federal and State False Claims Act and Whistleblower Protections
- Medicare Compliance Officer
- Government Programs Compliance Program - Medicaid
Government Programs Compliance Officer Conversations
Stay up to date with these messages from the Corporate and Government Programs Compliance Officer.
2026 Communications
2nd Quarter - Detecting Non-Compliance
1st Quarter - Preventing Non-Compliance
2025 Communications
4th Quarter - Compliance Communications
2nd Quarter - Training and Education
1st Quarter - Remaining Compliant in an Evolving Landscape
2024 Communications
4th Quarter - 7 Elements of an Effective Compliance Program - Elements VI and VII
3rd Quarter - 7 Elements of an Effective Compliance Program - Elements III and V
2nd Quarter - 7 Elements of an Effective Compliance Program - Elements II and IV
1st Quarter - 7 Elements of an Effective Compliance Program - Element I