The HPSM Compliance Program
The Health Plan of San Mateo is committed to conducting its business operations in compliance with ethical standards, contractual obligations, and all applicable state and federal statutes, regulations and rules, including those pertaining to Medicare, Medi-Cal and operations of health plans. HPSM’s compliance commitment extends to its business partners and delegated entities that enable HPSM to fully meet the needs of its members.
Our Compliance Program helps us serve our members ethically
We’re committed to practicing business in an ethical manner. Our Compliance Program is designed to:
- Assure compliance with all applicable federal and state laws governing HPSM
- Assure compliance with contractual obligations
- Detect violations of ethical standards
- Combat fraud and abuse
- Ensure effective education and training of staff and business partners
Reporting Potential Compliance Issues
There are a number of ways to report suspected or detected non-compliance or potential fraud, waste and abuse. HPSM has established a confidential Compliance Hotline for HPSM employees, providers, members, FDRs, and other interested persons to report any violations or suspected violations of law and/or HPSM’s Compliance Program.
You can call HPSM’s Compliance Officer, Ian Johansson, during business hours to report compliance issues. HPSM’s business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday (except holidays). To report an issue to Mr. Johansson, call 650-616-0050.
The toll-free Compliance Hotline is 1-800-826-6762.
The Compliance Hotline is accessible 24 hours a day, 365 days a year, excluding designated holidays. Callers can report issues anonymously. All reports will be referred to HPSM’s Compliance Officer and investigated.
Resources and Media
HPSM Policies on FWA
Personal Injury & Third Party Liability
Information for Lawyers/Representatives
- Inquiries on behalf of HPSM Medi-Cal Members - please read the Personal Injury and Third Party Liability Information Brief
- Inquiries on behalf of CareAdvantage, HealthWorx or Healthy Kids Members - please call Julie Mabana, HPSM TPL/COB Specialist at 650-616-0050
- Inquiries on behalf of San Mateo County ACE Participants - please contact the Finance Office of the San Mateo Medical Center. Contact Melby Portillo: email@example.com or Patty Ruiz firstname.lastname@example.org or call 650-573-2525