Corporate Compliance Notice
Compliance Hotline
(866) 802-3114
LESC’s Code of Conduct and Compliance Plan are intended to ensure LESC’s operations are conducted in compliance with all applicable laws and regulations as well as all LESC’s policies and procedures and in accordance with our mission, vision, and core values. It is the policy of LESC that all affected individuals (board members, employees, independent contractors, agents, volunteers, and interns) should comply fully with all applicable laws and regulations at all times.
LESC board members, employees, independent contractors, agents, volunteers, and interns have a duty to immediately report any actual or suspected illegal, unethical, or improper conduct. The LESC Compliance Hotline is a reporting mechanism that facilitates the reporting of possible violations when the regular channels of communication have proven ineffective, or are impractical under the circumstances.
If you have any questions or good faith concerns at any time regarding the legality or compliance of anything you or anyone else is doing on behalf of LESC, you are encouraged to utilize the reporting "chain of command" by contacting your supervisor or department head. If you are unsure about where to go with your concerns, or you feel uncomfortable reporting through normal channels of communication, or wish to raise the issue anonymously, you should access the Compliance Hotline through an anonymous phone call to (866) 802-3114. The Compliance Hotline protects your confidentiality and your anonymity, if requested.
Regardless of how a report is made, LESC prohibits retaliation in any form against anyone who, in good faith, reports a potential violation or who participates in an investigation, even if sufficient evidence is not found to substantiate the concern. LESC will take appropriate action against any individual determined to be engaging in retaliatory conduct.
In addition, the Compliance Officer may be contacted via phone at (212) 566-7776, cell: or email – greid@lesc.org
LESC has established a compliance program to detect and prevent fraud, waste, and abuse in the Medicaid program as well as organize provider resources to address compliance issues as quickly and efficiently as possible, and to impose systemic checks and balances to prevent future recurrence.
LESC has adopted, implemented, and maintained an effective compliance program, which is specific to organizational needs. Federal and state statutes, rules, regulations, and Medicaid program requirements are integrated into the compliance program, and we adhere to legal and ethical obligations promoting early detection and reporting. The compliance program is designed, implemented, and enforced and is effective in preventing, detecting, and correcting fraud, waste, abuse, and non-compliance with Medicaid program requirements.
LESC’s compliance program maintains documentation demonstrating that it has adopted and implemented the following elements of an effective compliance program.
Written Policies, Procedures, and Standards of Conduct
Compliance Officer and Compliance Committee
Compliance Program Training and Education
Lines of Communication
Disciplinary Standards
Auditing and Monitoring
Responding to Compliance Issues
LESC’s compliance program applies to:
billings
payments
medical necessity and quality of care
governance
mandatory reporting
credentialing
ordered services
vendors, contractors, subcontractors, agents, or independent contract oversight
other risk areas that are or should be, with due diligence, identified by the provider