Compliance and FDR Program

Inland Empire Health Plan (IEHP) is committed to conducting its health plan operations in compliance with ethical standards, contractual obligations under State and Federal programs, laws and regulations applicable to Medi-Cal and IEHP DualChoice. This commitment extends to our business associates and delegated entities that support IEHP’s mission to improve the delivery of quality, accessible and wellness based healthcare services for our community. 

Our Compliance Program is designed to:

• Ensure we comply with applicable laws, rules and regulations
• Reduce or eliminate Fraud, Waste and Abuse (FWA)
• Prevent, detect and correct non-compliance
• Reinforce our commitment to culture of compliance for which we strive
• Establish and implement our shared commitment to honesty, integrity, transparency and accountability

What is an FDR?

A First Tier, Downstream or Related Entity (FDR) is a delegated entity subcontracted on behalf of IEHP to provide health plan related services. 

FDR Requirements

FDRs are required* to follow IEHP’s policies and procedures, Code of Business Conduct and Ethics and other contractual requirements.  

FDR Resources

First Tier and Downstream Entities/Compliance Program Requirements Manual – This manual doesn’t pertain to IPA’s
IEHP Vendor FDR Manual Policy_Compliance Program Requirements_2021
IEHP Vendor FDR Manual Policy_FWA Requirements_2021
IEHP Vendor FDR Manual Policy_HIPAA Requirements 
IEHP Code of Business Conduct and Ethics 
Non Retaliation Policy
FDR Compliance Program Attestation
CMS Compliance, FWA and HIPAA training material
ICE FWA Training
ICE General Compliance Training

*For IPA requirements, visit the Provider Resources page. 

Inland Empire Health Plan (IEHP) expects Team Members and business entities doing business with IEHP to conduct business activities in an ethical and professional manner that promotes public trust and confidence in the integrity of IEHP. The Code provides guidance about the compliance culture at IEHP and the role that each Team Member, including Senior Management, Chief Officers, the Governing Board and our business partners, play in building and preserving that culture.

IEHP Code of Business Conduct and Ethics

The IEHP Compliance, FWA and Privacy Training Program focuses on to the elements of an effective Compliance Program, conduct and ethics and the Fraud, Waste and Abuse and Privacy Programs.

IEHP requires delegated entities to provide Compliance Training to  their employees, Providers, downstream entities, Board of Directors and Contractors within 90 days of hire/start date.

IEHP is committed to a culture of compliance, ethics and integrity, the goal of Compliance Training is to provide all associated parties the ability to demonstrate awareness of IEHP’s requirements, including regulations and policies and procedures associated with Compliance as it relates to daily work.

If you have questions or additional suggestions, please e-mail The IEHP Compliance Department at compliance@iehp.org

Compliance Fraud, Waste and Abuse (FWA) HIPAA Privacy and Security (PDF)

IEHP has the following resources available for reporting Fraud, Waste or Abuse, privacy issues and other Compliance issues:

Compliance Hotline: 1-866-355-9038
Fax: 909-477-8536

E-mail: compliance@iehp.org

Mail:
IEHP Compliance Officer
P.O. Box 1800
Rancho Cucamonga, CA 91729-1800

Online:
Report a Privacy Issue

Report a Fraud, Waste, or Abuse (FWA) Issue

Report Other Compliance Issues