FAQs

What is CMS?

CMS is the Centers for Medicare & Medicaid Services. Formerly known as the Health Care Financing Administration (HCFA), we are the federal agency responsible for administering the Medicare, Medicaid, SCHIP (State Children’s Health Insurance), HIPAA (Health Insurance Portability and
Accountability Act), CLIA (Clinical Laboratory Improvement Amendments), and several other health-related programs.

Additional information regarding CMS and it’s programs is available at http://cms.hhs.gov/about/default.asp.

The physician I work for has asked me to do something that I feel is improper and against the Compliance Plan. I don’t want to do something that is improper, but I’m afraid I may lose my job if I don’t do what I have been told. What should I do?

First, consider discussing the request with the physician to be sure you understand the facts and that he or she is aware of your concerns. If you feel that you cannot comfortably discuss the request with the physician, go to the next level in the “Compliance Chain”. Another resource that is available is the Confidential Hotline – (866) 631-5718. Do not take part in any improper or illegal activity that could affect your job or the reputation of OMH. OMH prohibits retaliation against employees who raise compliance concerns in good faith.

Whom should I contact if I think a OMH Employee or Agent is violating the Compliance Plan or the law?

The effectiveness of OMH’s Compliance Plan depends upon our employees and agents taking appropriate action if they suspect non-compliant conduct is occurring or is about to occur. If such an issue arises, you should first address your concerns through the “Compliance Chain”, if possible. If there is no resolution through the “Compliance Chain”, then move on to the “Reporting Ladder.” If possible, you should report the activity to your supervisor. If this is not possible, or the issue is not resolved at this level, then continue up the “Reporting Ladder”, to Senior Management. If there is no resolution within your working location or if you feel uncomfortable reporting to someone within your “Reporting Ladder”, you can call the Confidential Hotline – (866) 631-5718.

What is HIPAA?

HIPAA is the Health Insurance Portability and Accountability Act of 1996. HIPAA regulates the use and disclosure of protected health information.