Provider Compliance
It is Altura’s expectation that employees and providers immediately report to Altura any suspected compliance issues, such as noncompliant, unethical, or illegal behavior. Such behavior may include, but is not limited to, falsifying diagnoses, claims, or other documents; refusal to cooperate with state or federal audits or investigations; and other behavior. Such reports can be made directly to Altura’s Compliance Officer at 323-423-7228. Anonymous complaints of noncompliant, unethical, or illegal conduct may also be reported by calling Altura’s Compliance Helpline at 888-279-2449 or via the internet at www.MyComplianceReport.com (Access ID: AMSO).
You can also submit a written report to the compliance officer at:
Altura Management Services
Attention: Compliance Officer
1401 N Montebello Blvd
Montebello, CA 90640
The Compliance Helpline is available 24 hours a day, 7 days a week.
Altura will timely, consistently, and effectively act when noncompliant or unethical behavior is found. Such action will be appropriate to the seriousness of the violation and may include termination of employment (if applicable), withholding capitation, instituting monetary sanctions, or terminating a contract. Refer to the Participating Provider Agreement for further details on these measures. Downstream contractors shall ensure that it has established, implemented, and enforced disciplinary standards that are publicized to vendors and employees.
It is Altura’s expectation that providers and employees will cooperate with Altura’s efforts to monitor compliance.
Compliance Program Description released by Altura Management Services outlines the organization's commitment to maintaining high compliance standards among all Altura Team Members, contractors, and agents that furnish health care items or services. The program description applies to all Altura operations and requires adherence to Altura's Code of Conduct, policies and procedures, and the requirements of the Compliance Program. Altura has appointed a Compliance Officer who reports directly to the Altura Advisory Workgroup and the RBO's Board of Directors and has the authority to perform and monitor compliance risk assessments of the business activities engaged in by Altura. The Compliance Officer is responsible for developing an annual compliance program update and making regular reports regarding high-risk compliance matters to various stakeholders. The Compliance Program is intended to support and maintain Altura's present and future responsibility regarding its clients' participation in federal health care programs and aligns with Altura's core value of Unifying people & innovation to deliver high-quality care.
Link to Altura Compliance Pogram
The Business Code of Conduct outlines the ethical standards and expectations for employees, physicians, healthcare professionals, trainees, agents, board members, and volunteers at Altura Management Services. The Code emphasizes the importance of integrity, ethical behavior, and compliance with laws and regulations. It provides guidelines for reporting concerns, responding to violations, and maintaining a supportive working environment. The Code also addresses topics such as non-discrimination, physical safety, financial integrity, conflicts of interest, safeguarding information and resources, and responsible use of technology. Altura is committed to upholding these standards and taking appropriate disciplinary actions for noncompliance.
Link to Altura Code of Conduct
A Whistleblower is protected from retaliation. This includes, but is not limited to, protection from retaliation in the form of an adverse employment action such as termination, compensation decreases, or poor work assignments and threats of physical harm. Any individual who believes he/she is being retaliated against for reporting a violation or non-compliance must contact the Compliance Officer or make a report through the Compliance Hotline immediately. The right of a whistleblower for protection against retaliation, however, does not include immunity for any personal wrongdoing that is alleged, investigated, and substantiated.
Fraud, Waste, and Abuse (including FCA)
General Compliance
HIPAA
Code of Conduct
Link to Altura General Compliance Training
2024 Mental Health Parity Training