Learn about the Blue KC Compliance Program and the laws followed to maintain legal compliance.
We must conduct Blue Cross and Blue Shield of Kansas City (Blue KC) business in accordance with the law at all times.
One of the purposes of the Blue KC Compliance Program is to educate each of us about our obligations under the law. Blue KC is subject to a wide variety of laws and regulations, some of which address, for example, licensure requirements, accuracy in records, confidentiality concerns, patient treatment issues, and reimbursement of providers and/or Blue KC by Medicare, Medicaid, FEP and other Federal or State programs. Thus, in order to comply with this Standard, we must each be knowledgeable about the laws and regulations applicable to our lines of business, particularly those implicated by our individual duties. Blue KC will conduct regular training on compliance issues in general, with specific programs tailored to each of our individual lines of business as needed.
We each are responsible for ensuring our own compliance with laws and regulations that are applicable to Blue KC. We also are responsible for asking questions when we are uncertain about the propriety or legality of particular conduct, and for reporting to Blue KC management or the Compliance Office as soon as possible specific instances of noncompliance with applicable laws and regulations or these Standards of which we are or become aware.
Additionally, Blue KC attorneys have a specific responsibility to report evidence of a material violation of law, breach of fiduciary duty, or similar violation by Blue KC or any of its agents to Blue KC’s General Counsel or Chief Executive Officer (or equivalent thereof). If the General Counsel or Chief Executive Officer does not appropriately respond to the evidence (adopting, as necessary, appropriate remedial measures or sanctions with respect to the violation), the Blue KC attorney shall report the evidence to the Audit Committee of the Board of Directors, to another committee of the Board of Directors comprised solely of directors not employed directly or indirectly by Blue KC, or to the Board of Directors.