Compliance Program

Compliance Program Policies and Procedures

Our Compliance Department makes its policies and procedures available to providers. We are committed to keeping member information secure and complying with all federal and state regulations of our plans and practices. If you are new provider with us, we recommend that you review all of these policies as part of your on-boarding process.

Standards of Conduct

Community Health Plan of Washington’s Standards of Conduct
Community Health Plan of Washington’s Standards of Conduct (Spanish)

General Program Policies and Procedures

Compliance Audit Policy (CO363)
Compliance Program Policy (CO300)
Compliance Education Program Policy (CO293)
Compliance Department and Legal Counsel Policy (CO313)
Compliance Hotline Policy (CO319)
Cooperation with Audit and Investigators Policy (CO327)

Fraud, Waste and Abuse Prevention

Fraud, Waste and Abuse Policy (CO289)
False Claims and Whistleblower Protections Policy (CO310)

Privacy and Security of Protected Health Information

Member Privacy Policy (CO298)
Privacy Incidents and Breach Notification Policy (CO311)
HIPAA Security Policy (CO330)
HIPAA Privacy and Security Violations Policy (CO325)
Substance Use Disorder Records Use and Disclosure Policy and Procedure (CO367)

Compliance Today Newsletter

Volume Q2 2019
Volume Q1 2019
Volume Q4 2018
Volume Q3 2018
Volume Q2 2018
Volume Q1 2018
Volume Q4 2017
Volume Q3 2017
Volume Q2 2017
Volume Q1 2017

DID YOU KNOW...?

Provider Education and Training

Laughing Female Doctor at Desk in OfficeCHPW provides the resources you need to best care for members and stay compliant with local and federal regulations. Some training programs are optional and others are mandatory.

All CHPW contracted providers and clinic staff must complete the following: Model of Care Training, Patient Rights and Responsibilities & Advance Directives Training, and CMS Fraud, Waste, and Abuse Training.

Learn more about required training in the provider manual.

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We are now 
Community Health Plan of Washington
Medicare Advantage


With a new name comes new benefits.
Our  2020 Medicare Advantage plan details
will be available on October 1st, 2019.

 

Bookmark this page for updates!