Delegates must distribute their own written policies, procedures or standards of conduct or the UnitedHealth Group Code of Conduct to employees who support the administration or delivery of program benefits or services.
Standards of Conduct must be distributed within 90 days of hire and annually thereafter.
Delegates must retain proof of distribution for each employee.
Delegates working on our organization’s Medicare Advantage Part C or Part D programs must provide to their employees either their own written policies, procedures or standards of conduct that include all the required CMS elements, or the UnitedHealth Group Code of Conduct.
Delegates working on our organization’s Medicare Advantage (MA) or Part D programs must provide Waste & Abuse (FWA) and General Compliance training to employees who are involved in the administration or delivery of our MA or Part D benefits or services.
It is recommended that training be completed within 90 days of hire and annually thereafter.
It is recommended that delegates document and retain dates, methods, materials used and employees trained.
Confidential reports can be made to UnitedHealth Group’s Vendor Fraud Hotline: 877-401-9430
Key Regulatory and Guidance Information & Resources
Notification is required for excluded individuals or entities. UnitedHealth Group Compliance & Ethics Help Center: 800-455-4521
Hiring or contracting employees: Employees are defined as hired staff, management and temporary workers for your company or subcontractors that have involvement in or responsibility for a delegated core function in the administration or delivery of Medicare Advantage Part C or Part D health plan benefits and have access to PHI/PII.
Notification is required prior to moving services offshore that involve sharing of protected health information (PHI) or personal identifiable information (PII). Please contact your UnitedHealth Group representative to initiate the review and approval process.
Delegates must report any offshore subcontracting that involves receiving, processing, transferring, handling, storing, viewing or accessing PHI or PII.
Delegates must hold their downstream entities or subcontractors that support the delivery or administration of program benefits or services accountable for the same Compliance Program requirements.