Introduction to Quality Assurance/Corporate Compliance (QA/CC) for New Staff

ISSNY IS COMMITTED TO COMPLIANCE WITH STATE AND FEDERAL RULES, REGULATIONS, AND LEGAL REQUIREMENTS. THESE REQUIREMENTS GOVERN THE DELIVERY OF MEDICAID FUNDED SERVICES.

THE ISSNY QA/CC DEPARTMENT WORKS TO DETECT, PREVENT, AND AVOID FRAUD, WASTE, AND ABUSE.

ALL EMPLOYEES, VOLUNTEERS, AND CONTRACTORS ARE MANDATED REPORTERS.

NOTIFY QA/CC WHEN:

• You know or suspect suspicious behavior or identify a potential incident.
  • Including potential Medicaid fraud, waste, or abuse.
• You are concerned for a participant’s health, safety, and/or well-being.
• You know or suspect another party is falsifying documentation, such as:
  • You are asked to put inaccurate information on your timesheet (i.e. your timesheet does not reflect the hours you actually worked, you are asked to bill for a service that is not directly related to a valued outcome, etc.)
  • You are being persuaded to submit inaccurate reimbursements for mileage, staff activity fees, etc.
• You know or suspect a fellow staff is working with two participants and/or through two different Fiscal Intermediaries at the same time.
• You are asked to forge a participant or representative’s signature.
• You are encouraged not to report incidents or concerning behaviors to ISSNY.

Resources are always available at:  http://www.issny.org/compliance/

CONFIDENTIAL HOTLINE:
(833) -477-7287

QA/CC EMAIL:
QUALITYASSURANCE@ISSNY.ORG

Whistleblower Protections Disclaimer

Intimidation or retaliation will not be permitted against persons who report potential issues to the QA/CC Department. Any allegations of intimidation or retaliation will be thoroughly investigated.

Note:  Staff are mandated to complete annual ISSNY Trainings via Mind Flash. Human Resources distributes training via email. There is detailed guidance on QA/CC policies, procedures, and reporting processes in the Mind Flash Training Series. Staff are encouraged to contact QA/CC if there are any questions.

Created 04/09/26.