Vendor code of business conduct
High ethical standards: The key to our success
Our Code of Business Conduct is part of our way of life at BCN. Corporate ethics and corporate compliance are related concepts, but not identical. Ethics are part of the culture of an organization. Ethics provide a framework for decision making by guiding employees, interns, temporary agency personnel, contractors, consultants, vendors, external sales agents and members of the Board of Directors to always consider and do the “right thing.” This framework focuses on guiding workforce members, and others acting on behalf of BCN, on how and why to follow the rules.
As a vendor doing business with BCN you must strive to maintain high standards. Maintaining these high ethical standards is the key to our success.
The ethical standards are explained below and require all workforce members, the Board of Directors, and others acting on behalf of BCN, to act with honesty, integrity and impartiality when dealing with members, customers, providers, vendors, regulators, competitors, community, fellow employees, board and board committee members. To earn and keep their trust, you and all others acting on behalf of BCN must make every effort to avoid even the appearance of illegal or unethical conduct. You and all others acting on behalf of BCN must also take positive action to prevent or correct any improper conduct. This includes identifying and reporting known or suspected violations of the law or the code of business conduct.
Compliance with legal requirements
BCN is committed to full compliance with all laws and regulations that govern its business activities. There are many legal requirements that apply to BCN as an HMO and many that apply as a business. You must be aware of the legal requirements that govern your work and must comply with all legal requirements.
If you wish to confidentially discuss a situation that raises ethical issue, or report a violation, call the Anti-Fraud hotline at 800-482-3787.
To report Medicare and Medicaid specific issues or violations call the Medicare and Medicaid Anti-Fraud hotline at 888-650-8136.
Confidentiality
- BCN is required by state and federal law, and is strongly committed, to safeguarding the confidentiality of personal and protected health information. Such information includes, but is not limited to, a member’s medical history, treatment records, age or marital status. Confidentiality of member and patient personal medical information is required and expected of all BCN employees and contracted partners. You may have access to and use of medical records, medical information personal information about BCN members, such as marital status, age, medical care, cost and quality of health care services, complaints and grievances only if there is a business need to do so, and then, only the minimum necessary to complete the job function. All of this information is personal and highly sensitive and you may use and disclose it only as permitted or required by law, this contract and by our corporate privacy policy and procedures. Any breach of this obligation to maintain the confidentiality of protected health information will be viewed very seriously and may result in termination of contract.
- Follow the BCN Health Information Privacy policy, and appropriate procedures when using or disclosing member information or medical records.
- Access member information or medical records only when you have a medical or business need; never access this information for personal or non-business reasons.
- Discuss medical or personal information of members, patients or providers only when there is a business reason to do so and only with those persons who have a need to know for medical business reasons.
- Follow proper information system and record-keeping standards to safeguard member, patient or provider data and records.
- Copy or forward medical or personal information only when there is a legitimate medical or business need to do so and in accordance with the requirements of the BCN Health Information Privacy Policy.
- You must safeguard vigorously the company’s confidential information. Confidential or proprietary information includes any information that is not generally disclosed outside the company and that may be useful or helpful to our competitors. Examples include financial data, customer lists, business strategies and information or data that we have agreed by contract to maintain confidential.
Gifts and entertainment
- You may not give gifts to to BCN workforce members that could be perceived to influence the recipient’s sound business judgment. The purpose of business entertainment and gifts should be to create goodwill and to establish a good working relationship, not to gain an unfair or improper advantage, or to affect the exercise of a person’s sound business judgment.
- We respect the standards of other persons and entities with whom we deal. If their standards are more restrictive than ours, we will abide by their standards as they apply to their employees to the extent we are aware of them. Federal law prohibits gifts to federal employees, certain union leaders and to members of Congress, including any vendor, agent, provider, consultant or government official affiliated with government health programs such as Medicare or the Federal Employee Health Benefits Program (FEHBP). We must follow the law as it applies to gifts to these individuals. No marketing gifts may be given to prospective Medicare members exceeding a retail value for $15 and the gift must be provided regardless of enrollment.
You may not give or receive monetary gifts. Except as provided above, articles of nominal value ordinarily used for sales promotion may be exchanged. Similarly, and subject to these same exceptions, the exchange of such business courtesies, including reasonable means and entertainment consistent with social and business custom, is also permissible. You must exercise good judgment in offering or accepting meals, entertainment or other gratuities.
Conflicts of interest
- Vendors are required to avoid conflicts of interest with BCN.
Political activities
If you participate in political activities, including making personal political contributions to candidates or political parties, you must not create the impression that you are acting on behalf of BCN or BCBSM.
- Corporate political activity is highly restricted. As corporations, BCN and BCBSM are prohibited by law from using their funds to support candidates for federal, state or local office. BCN is the recipient of federal funds under its government contracts and must carefully monitor activities in this area to ensure that government funds are never used for political activities.
Prior criminal convictions
- BCN has a legal duty to identify and consider for exclusion from its business operations individuals whose prior conduct was illegal or inconsistent with the administration of an effective ethics and compliance program. The relatedness of the illegal activity or other misconduct to the specific responsibilities of the individual, as well as the recency of the misconduct will be taken into consideration when making hiring, contracting or retention decisions. BCN will not hire, retain, engage or contract with any individual or organization whose name appears on Federal debarment, exclusion or opt-out listings. The Medicare requirements will be incorporated into every vendor and contractor agreement requiring such disclosure.
Use of company e-mail and Internet
- Internal e-mail systems are acceptable for transmitting confidential data within the enterprise. Vendors may share protected health information using internal e-mail systems provided the vendor and recipient have a business need-to-know and the minimum necessary principle is applied. Our internal electronic mail systems are not secured source of data transmission and must not be used to send e-mail over the public internet.
- Messages traversing the internet are subject to potential public disclosure through innocent misdirection or deliberate intervention. If in doubt, assume that your message will end up on a public bulletin board on the Internet and judge the content and any attachment accordingly.
- An encryption function to secure messages that are being sent over the Internet should be used.
- It is a violation of the Code of Business Conduct to create or exchange messages or information or through the company’s internal and Internet electronic mail systems that are offensive, harassing, obscene, threatening or disparaging to others. Simply stated do not send anything via the electronic mail systems that you would not want disclosed publicly.
Records management
- Destruction of BCN corporate records under BCN’s Records Management Policy shall be suspended as necessary and appropriate under the direction of the Office of the General Counsel in order to preserve corporate records relevant to investigations of alleged wrongdoing, legal matters or required by court order. You are required to preserve relevant corporate records pursuant to such directives.
Government programs
- Compliance with all federal and state laws and programs, including Medicare, Medicaid and fraud, waste and abuse, are required.
page modified 08/31/2009