Thank you for being an HMSA vendor. We appreciate your partnership and commitment to building a sustainable health care system. With your help, we’re making strides toward a happier, healthier Hawaii.
Take a look at this article to learn about your obligations as an HMSA vendor and find resources to help answer any policy or compliance questions you may have.
Vendor code of business conduct
HMSA conducts business in compliance with all applicable laws, rules, and regulations. We expect the vendors we work with to follow our standards of conduct.
Read the Vendor Guide, which outlines key guidelines and policies you must follow during your relationship with HMSA. If you still have questions after you read the code, call your HMSA business contact or HMSA’s Compliance & Ethics Office.
Medicare fraud, waste, and abuse training
The Centers for Medicare & Medicaid Services (CMS) requires us to make sure our Medicare first tier, downstream, and related entities (FDRs) complete Medicare fraud, waste, and abuse (FWA) training within 90 days of contracting and every year after that.
To meet this training requirement, you can complete:
- The CMS Web-based compliance training.
- Your organization’s Medicare FWA training, which must meet CMS requirements.
Please document your training and retain the documentation for 10 years. Documentation should include training logs, reports, names, dates of employment, dates of completion, and passing scores (if captured).
If you’re wondering whether your organization is required to complete Medicare FWA training, please ask your HMSA business contact.
Medicare compliance policies and reporting
Effective Lines of Communication Policy
HMSA is committed to clearly and regularly reporting compliance and ethics issues to employees, managers, directors, contractors, agents, the C&E Advisory Committee, and its FDRs.
HMSA prohibits intimidation or retaliation against anyone who reports actual, suspected, or potential compliance and ethics issues in good faith.
Do you need to report noncompliance, including health care fraud, waste, or abuse, to HMSA?
Compliance and Ethics Officer
P.O. Box 860
Honolulu, HI 96808
Call our anonymous hotline:
Call our fraud hotline:
Medicare exclusion screening
Current or potential employees, managers, or contractors who are on the following lists shouldn’t perform any work related to the administration or delivery of HMSA Akamai Advantage or HMSA Medicare Part D plan benefits:
- Department of Health and Human Services Office of the Inspector General (OIG) List of Excluded Individuals and Entities
- General Services Administration Excluded Parties Lists System (EPLS)
If you’re a Medicare FDR, you must review these lists:
- Every month to make sure that your employees, managers, or contractors who administer or deliver HMSA Akamai Advantage or HMSA Medicare Part D plan benefits are not excluded from participating in federal health care programs.
- Before hiring or contracting individuals who will administer or deliver Medicare benefits.
For a list of FAQs about exclusions, visit oig.hhs.gov.