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.