Care 1st Health Plan | Compliance Newsletter | 2014 | English - page 1

2014
Dear Care1st member:
At Care1st we have a motto: “Yes,
it’s all about you.”We strive to
serve you, our member, and one of
the ways we do this is by running
an ethical company that follows
the law and respects your dig-
nity. Care1st staff members have
pledged to respect your privacy and
ensure that fraud, waste and abuse
are absent from this health plan.
Having had the privilege of being
the Care1st corporate compliance
officer for the last 15 years, I am
very proud to introduce the first
edition of our new
Compliance
Newsletter for Members
. This new
newsletter not only highlights what
we at Care1st are doing to serve
you better, but it also contains
important information related to
fraud, waste, abuse and privacy
issues—while providing the oppor-
tunity for you to assist us in giving
you the respect you deserve and in
locating and eliminating fraud and
C
ARE
1
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COMPLIANCE:
DEDICATED TO YOU
other practices that could inter-
fere with your receiving your full
Care1st benefits and services.
How Care1st Compliance
protects you
Care1st has a responsibility to
fight fraud, waste and abuse. This
task extends to helping you, our
member. An example of this pro-
tection is a call I recently received
from a Care1st member I will
call Mary. She went to her local
drugstore to pick up her monthly
prescription, but the pharmacist
refused to give her the medicine,
noting it had already been distrib-
uted. She contacted Care1st. We
learned that recently her purse had
been stolen—and in that purse
was her driver’s license, along with
the expensive drugs she needed to
take every day. We subsequently
learned that the thief had used
the information on the label of the
drug to order a refill and then used
the stolen license as identification
The Care1st fraud hotline is
877-837-6057
.
COMPLIANCE NEWSLETTER
FOR MEMBERS
to pick up the drug. Because the
drugstore had surveillance cam-
eras, law enforcement was able to
identify the imposter who picked
up the prescription, and he is now
in prison. Mary was able to get her
necessary medicine.
We were happy to assist Mary.
We do urge you to be careful with
the labels on any drugs you may
have, since they can be used by a
thief to obtain them from a drug-
store. In addition, if you have infor-
mation that anyone is stealing your
identity to make use of your Care1st
membership, please contact my
office immediately. Not only will we
work with the police to catch the im-
poster stealing your benefits, but we
will also make sure such thefts don’t
hurt your ability to obtain necessary
health care services.
Brooks Jones, CHC
Corporate
Compliance and
Privacy Officer
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