Standards of Conduct

These Standards of Conduct have been approved by the Chief Executive Officer and President of HealthAxis Group. It is applicable to all persons employed by HealthAxis Group including HealthAxis HealthOps, LLC, Beacon Health Solutions, LLC, and Analytics Partners, LLC, hereinafter collectively referred to as “HealthAxis” or “Company”.

All HealthAxis officers, directors, employees, and contractors hereinafter collectively referred to as “associates” shall adhere to the laws, rules, regulations, and policies of applicable governmental authorities and these Standards of Conduct. Failure to do so may be grounds for disciplinary action, up to and including termination of employment.

These Standards of Conduct include our Code of Ethics and are designed to guide associates in their daily business and workplace operations.

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Compliance Hotline

To report suspected violations of these Standards of Conduct or seek advice regarding a specific situation, employees may use:

Anonymous Compliance Hotline:
1-855-969-5859 (24 Hrs. Day / 7 Days a Week)

Compliance Email:
compliance@healthaxis.com

Policy Statement

It is the policy of HealthAxis to conduct its business affairs per the standards and rules of ethical business conduct and to abide by applicable laws, both in letter and spirit. In this, there is no room for compromise.

It is imperative that all associates of HealthAxis comply with the Standards of Conduct, immediately report any perceived violations, and assist in investigations of any allegations of wrongdoing. It is the policy of the Company to prevent the occurrence of unethical or unlawful behavior, to halt such behavior as soon as reasonably possible after its discovery, and to discipline associates who violate the standards contained in this code. This includes any individuals who fail to report a known violation.

No policy can be complete in all respects. The best safeguard against illegal or unethical conduct is for associates to:

  • Understand the laws, policies, and the Standards of Conduct affecting our activities on behalf of the Company Be thoughtful in exercising reason and good judgment in our day-to-day activities
  • Seek an explanation and assistance if any question arises regarding a violation or concern
  • Do the right thing, even when it is hard

HealthAxis instituted its Compliance & Ethics Program to educate directors, officers, and associates and sensitize them to potential ethical and compliance issues. The written description of the Compliance & Ethics Program, including methods of reporting concerns to Compliance leadership can be obtained from the Compliance & Ethics Department or the Human Resources Department. All associates are asked to complete and sign a form acknowledging receipt and understanding of these and the Standards of Conduct as a condition of their employment.

Any questions or comments about the Standards of Conduct, a complaint, legal or ethical action, or reports of violations of law, regulations or Centers for Medicare and Medicaid Services (CMS) program and any state regulatory requirements may be directed to the Company’s Chief Compliance Officer, Corporate Counsel or Human Resources Department.

It is the obligation of all associates to conduct themselves ethically and to report any Medicare/Medicaid program noncompliance or potential fraud, waste, or abuse to the Company, health plan, CMS, or a CMS designee (as appropriate). An associate who reports a suspected violation of the Standards of Conduct may choose to remain anonymous. Reported issues will be addressed and corrected immediately.

Any act in violation of law, ethics, or action contrary to the policy and purpose of the Standards of Conduct, or in violation of the Medicare/Medicaid program or Fraud, Waste and Abuse policy may be cause for disciplinary action, including verbal or written reprimands, suspension, termination, and/or reporting of the conduct to law enforcement.

Should any action taken by an associate result in sanctions or monetary fines to the Company or health plan partners, the Company may institute financial penalties and/or take legal action against that associate. The severity of the disciplinary action will be determined by the Chief Compliance Officer in consultation with the Corporate Counsel and the Human Resources Director, as appropriate.

Disciplinary action may also be taken against associates who fail to detect or report misconduct on the part of associates under their supervision.

Retaliation against and/or intimidation of any associate for good faith reporting of a violation of the Standards of Conduct, a law, or regulation is strictly prohibited and may be illegal.

Likewise, retaliation against and/or intimidation of any first tier, downstream or related entity (FDR) for good faith participation in the Company’s Compliance & Ethics Program including but not limited to reporting potential issues, investigating issues, conducting self-evaluations, audits, and remedial actions, and reporting to appropriate Company’s Chief Compliance Officer is also strictly prohibited.

However, if a reporting individual was involved in an improper activity, the individual may be disciplined appropriately, even if he or she was the one who disclosed the matter to the Company. In these circumstances, the decision to report the matter, and any subsequent cooperation, may be considered as mitigating factors in any disciplinary decision.

Employee Rights and Responsibilities

Rights and Responsibilities

Every associate is obligated to adhere to these Standards of Conduct strictly, always, and under all circumstances. Any associate who is aware of violations or potential violations is obligated to immediately advise their manager, the Compliance & Ethics Department, an officer of the Company, or the Chief Compliance Officer. If an investigation determines that an associate had knowledge of a policy violation, misconduct, or issue of noncompliance and did not report the issue, that associate may be subject to disciplinary action up to and including termination. If an associate has any uncertainty regarding legal or ethical issues involving Company affairs, the associate should seek advice or clarification from the Compliance & Ethics Department, the Legal Department, or the Human Resources Department.

The failure to seek advice or report Standards of Conduct violations could be detrimental to the individual and to the Company. Each associate should be aware that legal implications arising from any act, written record, correspondence, or other document created or maintained by an associate may be subject to future scrutiny by government officials or third parties.

It is the right of every associate to report to, make an inquiry of, or ask the advice of their manager or an officer of the Company, up to and including the Chief Executive Officer, regarding any possible violation of these Standards of Conduct, without risk to the associate’s job status or position. To secure this right, each person to whom a report is made, or from whom advice is sought, shall use every reasonable means available to keep the identity of any associate who requests such protection confidential. Confidentiality may be waived if the matter is turned over to law enforcement, is part of a legal proceeding or is prohibited by local law.

Ethics

It is Company policy to observe all applicable laws. Even where the law is permissive, the Company shall choose the course of the highest integrity. Local customs and traditions differ from place to place. However, honesty and integrity are cornerstones of good business in any culture. A well-founded reputation for trustworthy dealings is an invaluable asset. All directors, officers, and associates must understand that at HealthAxis, we care how results are obtained, not just that they are obtained. Each director, officer, and associate must always be honest and forthcoming, even when it is awkward or uncomfortable.

Protection of Reputation and Financial Strength

HealthAxis is committed to encouraging candid communication and transparency by keeping complete and accurate records and implementing appropriate controls. This commitment includes general business and financial records. Accurate documentation is always a priority. No associate should enter into any transaction knowing that it is anything other than what is described in the agreement and supporting documentation.

All transactions must be transparent and properly recorded. There must be no disbursement or receipt of Company funds outside the Company’s system of accountability. Meaning, no “off-books” or “unofficial” funds, payments, or transactions; and all funds, payments, and transactions must be recorded following applicable accounting practices.

Our records must be complete and accurate, fully reflecting the Company’s activities and transactions, including claim payments, medical billing documentation, expenses, purchases, accounts receivable, and sales. The information derived from these records is provided to the Company’s shareholders, as appropriate, as well as governmental agencies; therefore, processes must follow applicable accounting principles and all relevant laws and regulations. HealthAxis’ reputation for integrity, as well as its financial strength, depends on this. It is difficult to delineate every practice that is or is not permissible, but certain general guidelines can be set forth.

A payment is not prohibited if:

  • It is illegal
  • It is inconsistent with HealthAxis’ defined values
  • No record of its disbursement or receipt is entered into the Company’s accounting records
  • It is entered into the Company’s accounting records in a manner that is false or misleading

The Company also adheres to all applicable local tax transfer pricing regulations, including documentation and notification requirements. Where an appropriate market price can be determined, intracompany transactions will be priced at a level consistent with fair market value. In the absence of market pricing, charges for intracompany transactions will be based on cost and reasonable profit data to approximate fair market value. Further, material intracompany transactions are supported by intracompany agreements, which among other things, identify the parties involved in the transaction and the basis for the pricing. For all intracompany transactions, transfer pricing will be regularly reviewed (including reviews by independent third parties) to ensure compliance with Company policies.

Fraud, Waste and Abuse (FWBA) Prevention Program

The Company is committed to developing a comprehensive program at the corporate and operating unit level for the prevention, detection, and reporting of fraud, waste, and abuse. The FWA Prevention Program encompasses industryrecommended practices and processes and implements them throughout the Company. HealthAxis’ Special Investigations Unit (SIU) oversees the FWA Prevention Program.

The FWA Prevention Program is designed to prevent and reduce fraud, waste, and abuse among providers, members, associates, and subcontractors. It may also help to prevent potential health risks to members. A toll-free Fraud, Waste, and Abuse Hotline is available to associates, clients, members, business partners, and providers. For more information, see ‘How to Report Concerns and Possible Violations’ in the Standards of Conduct.

False Claims Act

Under the U.S. False Claims Act (FCA), any individual or entity that knowingly keeps an overpayment or submits a false or fraudulent claim for payment of U.S. Government funds can be held liable for significant penalties and fines. The FCA applies to claims by health care organizations to Medicaid, Medicare, and other government sponsored health care programs. Potential fines for violating the FCA include a penalty of: (1) up to three times the amount of the damages sustained by the government for each false claim; (2) additional civil penalties for each false claim; and (3) payment of the cost of the civil action by the entity or individual that submitted the false claims. Criminal penalties may also apply. If found liable under the FCA, the entity or individual may also be excluded or suspended from participating in all federal health care programs.

The FCA contains “whistleblower provisions” that allow people with evidence of fraud against the government to sue, on behalf of the U.S. Government, to recover the stolen funds. In some cases, the U.S. Government may join the whistleblower suit. If a whistleblower suit is ultimately successful, the person who initially brought the suit may be awarded a percentage of the recovered funds.

The FCA also contains a provision that protects the whistleblower from retaliation by their employer. This provision applies to any associate who is discharged, demoted, suspended, threatened, harassed, or discriminated against because of the associate’s lawful acts in a whistleblower suit. HealthAxis affords associates all protections required by the FCA.

In addition to the U.S. FCA, several U.S. states and other countries also have false claims legislation with similar penalties that work to discourage fraud perpetrated against local governments.

Potential Violations of the False Claims Act

  • Billing for goods and services that were never delivered or rendered
  • Double-billing – charging more than once for the same goods or service
  • Falsifying time sheets - billing for made up hours or employees not working
  • Not reporting overpayments
  • Being awarded a contract by offering kick- backs or bribes
  • Inflating a bill with more expensive billing codes than what service was rendered
  • Ordering unnecessary tests in order to received higher reimbursements
  • Unbundling billing codes

Protecting Confidential Information

It is the duty of all associates to protect confidential and proprietary Company information.

What Does It Look Like?

  • Obtaining a signed confidentiality agreement from client/vendor before sharing any Company information
  • Not sharing passwords with co-workers or friends
  • Locking laptop every time you walk away from it
  • Not using unsecured shared wi-fi at coffee shops and other public spaces
  • Locking file cabinets containing contracts
  • Password protecting files sent electronically to clients or outside parties

Work Product

Any work product conceived, created, or changed by associates, individually or jointly, during employment belongs to the Company. This includes writings, models, processes, technologies, inventions, discoveries, ideas, and other work products of any nature. Associates may not share, publish, claim, or further develop any Company work product during or after their employment unless they have express, written permission to do so from the Legal Department.

Intellectual Property

HealthAxis respects the intellectual property of others, including clients, suppliers, vendors, business partners, providers and competitors.

Associates are expected to comply with applicable licensing, royalty, and rental agreements and may not make unauthorized copies of software or any other copyrighted material, and may not improperly download, share, or use competitor information. It is both illegal and unethical to break copyright laws or licensing agreements.

Data Privacy

As a healthcare-related organization with operations across the U.S., HealthAxis has access to protected and confidential personal data (e.g., health info, personally identifiable information, etc.) of members, providers and associates. The Company is committed to handling this data responsibly and respecting the rights of all data subjects. The Company and every associate has a responsibility to safeguard personal data maintained by the Company.

Whenever working with personal data, associates must ensure that they follow applicable policies and procedures and comply with local laws and regulations. For example, when accessing or disclosing personal information, associates must ensure that a legitimate business reason exists for the access or disclosure, they share only the minimum amount of information necessary to achieve that business purpose, and protected data is transmitted over a secure network consistent with the Company’s defined processes and data sharing agreements.

Several regulations govern the access and exchange of personal data, such as the Health Insurance Portability and Accountability Act (HIPAA). HealthAxis is committed to complying with these and all other relevant data privacy laws and regulations to ensure we appropriately safeguard confidential information.

Any confirmed or suspected breach of personal data must be reported immediately to your Chief Compliance Officer or a member of the Compliance & Ethics Department.

Records, Information Management & PHI

Many laws and regulations govern how we maintain Company records, including business, financial, employee and member records. Officers and associates are responsible for ensuring that Company records are retained and disposed of following all applicable laws, regulations, and the Company’s record management policies. Records include information stored in various media, including paper, electronic, audio, or video.

Record retention time frames and directives depend on the content, type of record involved, and which laws or regulations apply. Officers and associates are responsible for understanding the record retention schedule for our records. Never alter or destroy any records requested for a government investigation or legal proceeding, or documents that might be relevant to an expected investigation or proceeding.

The Company is committed to conducting business in compliance with national standards for privacy, security, and electronic transactions of Protected Health Information (PHI) as set forth in the Health Insurance Portability and Accountability Act (HIPAA) and modified by the HITECH Act.

All associates of the Company are expected to follow the Company’s HIPAA policies and procedures. Confidential and proprietary information regarding the client’s members, including but not limited to medical and financial information, must be protected.

Confidential information should not be disclosed to anyone outside of the Company, including friends, family, business or social acquaintances, customers or suppliers. Company associates are not permitted to disclose confidential member information to any unauthorized person. An associate’s obligation to not disclose such information exists both during and after employment or contract with the Company.

Information Security

Information security at HealthAxis is everyone’s responsibility. Social engineering, malware, phishing, and other cyber or physical threats can compromise the integrity, confidentiality, and availability of Company systems and result in significant breaches of confidential information.

As HealthAxis’ first line of defense against attacks, associates are essential to supporting HealthAxis’ culture of information security. HealthAxis works to protect information assets through several technical, administrative, and physical controls intended to proactively address security incidents and reduce their potential impact.

To minimize information security risk and help secure the Company’s information assets, it is the responsibility of every associate to adhere to the Company’s information security policies.

Best Practices

  • Enabling multi-factor authentication to access Company systems
  • Providing associate resources and training to promote information security awareness and reduce security risk
  • Ensuring appropriate encryption technology is in place for the secure storage and exchange of confidential data
  • Implementing automated tools for detecting and responding to threats

Media Relations

Responding to External Media Inquiries

Communication is a critical element of creating a successful and highly engaged organization. HealthAxis is committed to being forthright and honest by providing appropriate parties, including the media and external stakeholders, timely and accurate information about the Company and its activities. However, it is in HealthAxis’s best interest to exercise appropriate caution about how, and by who, official information about the Company is released.

When the media or other third parties contact HealthAxis requesting information, the responses can have far-reaching implications. Therefore, at the time, HealthAxis provides information on contracts, operational strategies, financial results, or other activities, the team must ensure that the message is accurate and appropriate for public release.

In addition, HealthAxis is committed to complying with applicable legal and regulatory requirements regarding how and when information is disclosed.

There are assigned personnel who handle requests for information or interviews about the Company and its operations. Contact the Compliance & Ethics Department if there are any questions.

Any requests for business, confidential or proprietary information regarding HealthAxis or any of its subsidiaries, must be sent to a member of or the entire HealthAxis Executive Team for review and ultimate response directive. These include but are not limited to information on financials, possible acquisitions, divestitures, the status of corporate operations, or changes in senior management, among other things.

Additionally, we must be aware of the possible impact of comments made in public forums such as conferences and social media sites. To avoid confusion and dissemination of false or misleading information, associates who post comments about the Company on any platform should make it clear that they are not speaking on behalf of HealthAxis.

No one should post any information about members, clients, trade secrets, proprietary information, insider financial information, sensitive or confidential operational activities.

External Social Media

The use of social media by associates, including information shared through instant messaging, texts, blogs, and social networking sites, can have a far-reaching and permanent impact on our Company. Because social media enables information to spread quickly, we must consider how social media has the potential to impact HealthAxis’ business, brand, and reputation.

Associates are responsible for their content that is accessible through social media channels. When using social media for personal reasons, make it clear that associates do not speak on behalf of the Company.

Nothing in the Company’s social media policies is designed to interfere with, restrain, or prevent associate communications about wages, work rules, or other terms and conditions of employment. Associates have a right to engage in or refrain from such activities.

Associates can contact a member of the corporate Marketing Communications Department with questions regarding social media communications or refer to social media policies and procedures.

Social Media Examples:

  • Facebook
  • LinkedIn
  • YouTube
  • Instagram
  • Snapchat
  • Twitter
  • Online Blogs
  • Dating Apps
  • Discussion Boards

Speaking Engagements

As with social media, our utilization of external speaking platforms can significantly impact the Company’s reputation and business activities. Associates must submit and obtain prior approval from the Chief Executive Officer or Chief Operating Officer with final review by the Chief Compliance Officer before all speaking engagements for which they will be addressing an audience (of any size) with the Company name attributed to their title. Such speaking engagements include seminars, fairs, conferences, events, speeches, presentations, panel discussions, podcasts, and other public-facing opportunities.

Expectations for Electronic Communications

HealthAxis is committed to respecting privacy and keeping important personal information confidential. We expect the same from associates when utilizing information technology tools such as e-mail, internet access, Zoom, Microsoft Teams or similar applications.

HealthAxis’ Internet and e-mail systems are provided to help associates do their job and should be used primarily for business purposes. The Company understands that, under certain circumstances, limited, occasional, and infrequent personal use may be acceptable. If, however, associates spend excessive time using e-mail or the internet for non-business matters or personal use interferes with the job duties, associates may have their access restricted and could face other disciplinary action.

Business or personal messages, including any attached electronic files/content sent or received using e-mail, internet/intranet, instant messaging, telephone and voicemail systems, or other Company assets are property of HealthAxis. All remain subject to review by the Company at any time.

Lawfully monitoring and reviewing Company electronic communications systems is necessary to meet obligations to maintain member and patient privacy, protect personal data, guard against data theft, avoid dissemination of insider information and trade secrets, and investigate reports of unlawful behavior.

Additionally, in the event HealthAxis becomes involved in litigation or an investigation, associate e-mails or work history may be turned over to third parties. Associates should never send e-mails or other electronic communications that associates would not write in a printed document.

Associates’ work, consisting of e-mail, paperwork, computer files, products, customer calls, or other interactions, belongs to HealthAxis. All work is subject to review when permitted by law. Additionally, business equipment, including computers, desks, and file cabinets, belongs to HealthAxis and is also subject to search or investigation for business and security reasons. Contact the Compliance & Ethics Department if you have any questions regarding electronic communications.

Conflict of Interest

HealthAxis is committed to communicating candidly, openly, and honestly with its associates. Associates are expected to do the same when dealing with HealthAxis. Conflicts of interest include situations that create an actual, potential, or perceived conflict and arise when loyalty is divided between the Company’s best interest and personal interests. Life is full of situations with multiple interests, and there is nothing unethical about that. The ethical complications arise when we act based on personal interests rather than in the best interest of HealthAxis.

If an associate wishes to engage in a transaction or activity that is, could be, or could appear to conflict with HealthAxis’ interests, the associate must first make a full written disclosure to the Compliance & Ethics Department and gain approval before engaging in the transaction or activity. The Compliance & Ethics Department will evaluate the written disclosure and decide. Additionally, directors, officers, and associates are required to complete a Conflict-of-Interest Disclosure annually. Following these procedures will ensure that the conflict of interest provision is not violated.

Conflicts of Interest Examples

  • Working for or owning a Company that does business with the Company’s competitors
  • Freelancing for a competitor
  • Using Company information for your own personal gain or another Company
  • Not disclosing a potential client /vendor is a friend or family member
  • Working for an outside Company that interferes with your position
  • Supervising a person, you have a romantic relationship with

Gifts and Bribes

HealthAxis is committed to doing the right thing when dealing with business courtesies. This includes gifts given or received.

HealthAxis trusts all directors, officers, and associates to use their best judgment in these matters. We should always act in accordance with this guide, applicable laws, and the Company’s best interest. We may never use our position within the Company to take unfair advantage of anyone seeking to do business with HealthAxis. Associates must restrict vendors, suppliers, or other contractors from using business gifts or favors to influence business decisions. Associates are not to use their position in the Company to solicit a kickback for assigning or referring members or patients. Further, cash payments may never be made to or solicited from associates of competitors, suppliers, customers, or government entities, and no corporate checks are to be written to “cash,” “bearer,” or third-party designees of a person entitled to receive payments from the Company.

Giving or receiving bribes or other forms of payment designed to influence decisions is never acceptable.

No associate, or anyone acting on behalf of the Company, may offer or give anything of value for the purpose of improperly influencing a government or private contract, award, consent, legislation, or other action which would give the appearance of attempting to influence such actions. This includes, but is not limited to, paying lobbying fees to affect a contract or award. During bid submissions or obtaining government contracts, specific questions may be asked of the Company regarding lobbying fees. The Company is required to answer these questions truthfully and disclose any relationships that may violate these Standards of Conduct.

Acceptable Gifts

Associates may seek approval from the Compliance & Ethics Department to give or receive a business gift or entertainment more than the amount of $100, if the gift meets the following criteria:

  • Is not cash
  • Is consistent with customary business practices
  • Is not excessive in value
  • Cannot be construed as a bribe or kickback
  • Does not violate any laws or regulations

Unacceptable Gifts

It is unlawful for associates, business partners, and anyone else acting on behalf of the Company to offer directly or indirectly anything of value to a government official or their representative to:

  • Obtain or retain business
  • Influence business decisions
  • Secure an unfair advantage

Associate’s personal activity may be attributed to HealthAxis and could impact the Company’s ability to do business within jurisdictions where the violations occurred. The penalties associated with violating this requirement are severe for both associates and the Company and can result in disciplinary action, fines, and criminal prosecution.

Any reports of potential bribery or corruption will be considered confidential unless disclosure is required by law. U.S. federal law protects “whistleblowers” who report, in good faith, these types of issues, and the law prohibits retaliation against such individuals. Associates may contact the toll-free Compliance & Ethics hotline, available to all associates, members, patients, business partners, and network providers to make anonymous reports.

Political Activities

HealthAxis is committed to being upstanding and accountable when participating in political processes. HealthAxis, as a business, expresses its views on local and national issues that affect its operations. The Company may be allowed, in certain circumstances, to make corporate contributions to political candidates or office holders, but applicable laws are very restrictive. Restrictions also exist regarding how the Company may solicit associates for contributions for political causes or candidates.

HealthAxis respects associates’ rights to participate in political activities on their own, or on behalf of any cause or candidate the associate supports. However, the Company asks that associates refrain from engaging in political activities at work and strictly follow Company’s policies.

Associates must be careful not to use HealthAxis’ name, property, or other resources in any way to support personal political activities and should exercise discretion in discussing personal political views with business contacts.

Individual associate involvement or contributions to political or legislative matters should never be represented as coming from or being endorsed by HealthAxis, its officers, or directors. HealthAxis does not reimburse employees for personal political contributions, and their compensation will not be increased or adjusted to reflect political contributions made.

Nothing of value, including Company funds, property, or work time, shall be contributed, expended, or reimbursed to any candidate for any campaign purpose in a manner that is inconsistent with these Standards of Conduct. This includes contributions in connection with any national or local election or political convention where a candidate or nominee is to be voted upon or otherwise elected.

Inclusive and Responsible Work Environment

HealthAxis is committed to maintaining and promoting a diverse and inclusive environment. Having a workforce reflecting the communities we serve and the communities we will serve in the future is the key to growth and innovation. Diversity and inclusion are core values reflected in our workforce and in our engagements with the communities we serve, our suppliers and vendors, our providers, and our business partners.

Anti-Harassment & Equal Opportunity

For purposes of these Standards of Conduct, harassment includes any verbal or physical conduct intended to threaten, intimidate, or coerce an associate, coworker, or any person working for or on behalf of the Company. The Company prohibits harassment and discrimination of any individual based on the person’s age (40 and over), race, color, religious creed (including religious dress and grooming practices), national origin or ancestry, mental and physical disability (including HIV and AIDS), medical condition (including cancer), pregnancy (including childbirth, breastfeeding, and related medical conditions), sexual orientation, gender, gender identity and gender expression, marital status, military and veteran status, uniform service member status, genetic information, request for Pregnancy, Disability, Family Care, or Medical Leave, or any other legally protected status under applicable law.

Further, it is the policy of the Company to provide all associates and candidates for employment with opportunities based solely upon their talents, skills, and abilities.

HealthAxis will provide a business and workplace environment that is free of these examples but not limited to them. For more information on our inclusive workplace, including information on how to report a concern, please see the Company’s Human Resources policies and HealthAxis’ Employee Handbook.

Examples of Harassment

  • Slurs, epithets, or threats
  • Derogatory comments
  • Unwelcome jokes
  • Sexual advances and requests for sexual favors
  • Other unwanted verbal or physical contact (e.g., uninvited touching or sexually related comments)

Workplace Safety

HealthAxis is committed to protecting the safety, health, and well-being of all associates and individuals in our workplace. This includes maintaining an environment that is free from intimidation and acts or threats of violence.

All associates are expected to comply with the Company’s workplace violence prevention policies and should help maintain a safe work environment by promptly reporting any threatening or violent conduct. In addition, HealthAxis maintains an alcohol and drug-free atmosphere focused on preventing risk to our associates, the members, and patients we serve, and members of the public who may interact with our business. Resources such as the Company’s Employee Assistance Program may be available to employees seeking support related to drugs or alcohol.

Employee Community Engagement

HealthAxis recognizes the importance of community engagement. Through the Company’s Volunteerism Policy, employees are encouraged to engage with the communities they serve by building and maintaining relationships with local community organizations.

The Company supports community partners through volunteer work, grant awards, board participation, corporate in-kind donations, donation drives, and event sponsorships. Associates should not participate in community engagement volunteer activities on behalf of or as representatives of the Company without the prior consent of the executive management. For more information regarding employee community engagement, please refer to the Company’s Volunteerism Policy or contact a member of the Human Resources team.

Employment Prohibitions

HealthAxis Company

As a third-party administrator who services providers of government-sponsored health plans, HealthAxis may not employ or contract with anyone who has:

  • Been excluded from participation in U.S. health care programs
  • Been convicted of certain crimes
  • Pled guilty or “no contest” to certain crimes

HealthAxis Associates

Additionally, to remain compliant with regulatory and legal requirements, associates must immediately notify their manager and the Human Resources Department when any type of license (e.g., motor vehicle, professional, etc.) that is required to perform their job:

  • Expires
  • Is revoked
  • Is suspended

Risk Management

HealthAxis has a risk management process by which risks are identified, assessed, and reported quarterly to the Compliance Committee. Leaders are expected to take ownership of the risks within their area and ensure that effective mitigation activities are in place to control or manage those risks. In addition, all associates have a responsibility to identify emerging business risks and escalate those concerns to management promptly.

Business risks can take the form of operational deficiencies, inappropriate conduct, violations of Company policy, illegal activities, or other issues. If an associate does not feel comfortable reporting concerns to a member of management, please contact the Compliance & Ethics Department.

Audits and Monitoring

HealthAxis will routinely engage in external and internal audits, reviews, and investigations. The Compliance & Ethics team will develop an annual audit work plan that will cover audits in all operational areas of the organization related to Medicare contracts. The annual audit work plan will be approved by the 1st quarter of each calendar year. Progress and results of auditing and monitoring activities will be shared with the Compliance Committee.

Associates must cooperate fully with all inquiries and provide immediate notification to their business unit’s manager, the Compliance & Ethics Department, and the Chief Compliance Officer when any of the following occurs:

  • Service of a government subpoena
  • An official request for information from a third party
  • Execution of a search warrant
  • Any unscheduled audits by a federal or state agency
  • Request to appear or testify before a grand jury, government agency, or similar organization
  • Notice that a regulator or similar authority has begun an investigation
  • Request for an inspection or interview by a government agency (other than routine requests)
  • Notice from a government authority imposing or threatening substantial fines, penalties, or other action

Compliance and Ethics Program

HealthAxis’ Compliance & Ethics Program is designed to promote adherence to appropriate standards of business conduct throughout all aspects of the organization’s operation and to ensure conformance with applicable federal and state regulatory obligations by the organization and its associates, committee members, consultants, providers, FDRs, and vendors.

The company complies with all federal and state requirements, including but not limited to:

  • Title XVIII and XIX of the Social Security Act
  • Medicare regulations governing Parts C and D found at 42 C.F.R. 422 and 423 respectively
  • Patient Protection and Affordable Care Act (Pub. L. No. 111-148, 124 Stat. 119)
  • False Claims Acts (31 U.S.C. §§ 3729-3733)
  • Federal Criminal False Claims Statutes (18 U.S.C. 287,1001)
  • Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b))
  • The Beneficiary Inducement Statute (42 U.S.C. § 1320a-7a(a)(5))
  • Physician Self-Referral (“Stark”) Statute (42 U.S.C. § 1395nn)
  • Health Insurance Portability and Accountability Act (HIPAA); (Public Law 104-191)
  • Fraud Enforcement and Recovery Act of 2009
  • Fraud and Abuse, Privacy and Security Provision of the Health Insurance Portability and Accountability Act, as modified by HITECH Act
  • Prohibitions against employing or contracting with persons or entities that have been excluded from doing business with the Federal government (42 U.S.C. 1395w-27(g)(1)(G)
  • Applicable provisions of the Federal Food, Drug, and Cosmetic Act
  • All sub-regulatory guidance produced by CMS and HHS such as manuals, training materials, HPMS memos, and guides
  • Articles 44 and 49 of the New York State Public Health Law

The Company’s Compliance & Ethics Department is responsible for implementing the Compliance & Ethics Program; implementing, monitoring, maintaining, and enforcing the Standards of Conduct and Code of Ethics; developing and adopting policies and procedures pertaining to ethical conduct; ensuring prompt response to inquiries and reported violations; and imposing disciplinary actions related to compliance violations.

The Company’s Chief Executive Officer and President are committed to the Company’s compliant, lawful, and ethical conduct. It is every associate’s responsibility (from top to bottom) to prevent, detect and correct fraud, waste, and abuse and report instances of suspected non-compliance to the Company’s Chief Compliance Officer, CMS, CMS’ designee (if appropriate) and/or to law enforcement. The Company’s Compliance & Ethics Program specifies individual responsibilities and actions regarding non-compliance, fraud, waste, and abuse.

HealthAxis’ Compliance & Ethics Program is intended to demonstrate in the clearest possible terms the absolute commitment of the Company to the highest standards of compliance and ethics. That commitment permeates to all levels of the organization. The Compliance & Ethics staff and Compliance Committee, chaired by HealthAxis’ Chief Compliance Officer, oversee the Compliance & Ethics Program. All individuals involved in the process are prepared to support associates in meeting these Standards of Conduct.

The Company’s Compliance & Ethics Department is responsible for implementing the Compliance & Ethics Program; implementing, monitoring, maintaining, and enforcing the Standards of Conduct and Code of Ethics; developing and adopting policies and procedures pertaining to ethical conduct; ensuring prompt response to inquiries and reported violations; and imposing disciplinary actions related to compliance violations.

The Company’s Chief Executive Officer and President are committed to the Company’s compliant, lawful, and ethical conduct. It is every associate’s responsibility (from top to bottom) to prevent, detect and correct fraud, waste, and abuse and report instances of suspected non-compliance to the Company’s Chief Compliance Officer, CMS, CMS’ designee (if appropriate) and/or to law enforcement. The Company’s Compliance & Ethics Program specifies individual responsibilities and actions regarding non-compliance, fraud, waste, and abuse.

HealthAxis’ Compliance & Ethics Program is intended to demonstrate in the clearest possible terms the absolute commitment of the Company to the highest standards of compliance and ethics. That commitment permeates to all levels of the organization. The Compliance & Ethics staff and Compliance Committee, chaired by HealthAxis’ Chief Compliance Officer, oversee the Compliance & Ethics Program. All individuals involved in the process are prepared to support associates in meeting these Standards of Conduct.

How to Report Concerns or Potential Violations

The Company’s Chief Compliance Officer is responsible for all aspects of the Compliance & Ethics Program. The Chief Compliance Officer, along with the Compliance & Ethics Department, is the Company’s link to important compliance information and education. Associates are encouraged to seek guidance concerning any obligations and report any instances of non-compliance.

Secure Website

  • Easy 24/7 access
  • Claimants will be provided a tracking number to access progress reports of their claims, should they desire.

Compliance Hotline #: 1-855-969-5859

  • Hotline is toll-free 24/7
  • Reports can be made anonymously and confidentially
  • Effective 1/15/2022, all calls to the hotline are directed to a contracted vendor

Compliance Email: compliance@healthaxis.com

  • Easy 24/7 access

Code of Ethics

  • All associates shall make good faith efforts to report suspected incidences of non-compliance, violations of federal, state, or local laws and regulations and fraud, waste, or abuse.
  • All associates shall treat each other equally, fairly and with respect, providing an environment free from harassment, discrimination, and violence.
  • All associates shall maintain accurate records and abide by all retention and disposal policies established by the Company.
  • All associates shall protect the confidentiality of Company information and intellectual property and that of its vendors and business associates.
  • All associates shall use all reasonable efforts to prevent the disclosure of the protected health information of any member unless such information is otherwise required by law or authorized.
  • No associate of the Company shall disclose confidential Company information gained by reason of his or her official position or otherwise use such information for his or her personal gain or benefit.
  • No associate shall use their position within the Company to act on behalf of the Company, unless so authorized.
  • No associate of the Company shall accept or solicit any gift, favor, or service that might reasonably tend to influence their discharge of official duties or that he or she knows or should know is being offered with the intent to influence his or her official conduct.
  • No associate of the Company shall intentionally or knowingly solicit, accept, or agree to accept any benefit for having exercised his or her official powers or performing his or her official duties in favor of another.
  • No associate of the Company shall accept employment or engage in any business or professional activity that he or she might reasonably expect would require or induce him or her to disclose confidential Company information acquired by reason of his or her official position or which could reasonably be expected to impair his or her independence of judgment in the performance of his or her professional duties.
  • No associate of the Company shall transact any business in his or her official capacity with any business entity that is of like competing interest of the Company, including entities in which he or she owns a substantial interest.
  • No associate of the Company shall make personal investments that could reasonably be expected to create a substantial conflict between his or her private interest and the interests of the Company.

If you have any questions, reach out to the HealthAxis Compliance Team at compliance@healthaxis.com.