Compliance Information

CalOptima’s Commitment to Compliance

General Information

CalOptima’s Compliance Program

CalOptima is committed to upholding the highest ethical standards. We comply with applicable laws, regulations and health care program requirements as well as CalOptima’s Code of Conduct, policies and requirements. CalOptima’s Compliance Program applies to our four programs: Medi-Cal, OneCare, OneCare Connect and Program of All-Inclusive Care for the Elderly.

CalOptima’s Compliance Program incorporates all the elements of an effective compliance program as recommended by the Office of the Inspector General and required by the Centers for Medicare & Medicaid. The Compliance Program is continually evolving and may be modified and enhanced based on compliance monitoring and identification of new areas of operational, regulatory or legal risk. CalOptima requires that CalOptima Board members, employees, and First Tier, Downstream and Related Entities (FDRs) conduct themselves in accordance with the requirements of CalOptima’s Compliance Program as well as CalOptima’s Code of Conduct.

If you see any activity that you think is fraudulent or wasteful, we strongly encourage you to call our Compliance and Ethics Hotline at 1-877-837-4417 or report the activity using the form below. You do not have to give your name to report the activity.

Triangle with exclamation point icon

Report Fraud or Abuse Call our Compliance and Ethics Hotline at 1-877-837-4417 or report it using our form. You do not have to give your name to report fraudulent activity.

Arrow Icon

First Tier, Downstream and Related Entities Learn about compliance for CalOptima contracted entities.

Arrow Icon

Compliance Resource Links View resource documents, training and educational tools.

Terms and Conditions Download PDF Icon View CalOptima’s standard terms and conditions. The terms and conditions printed, written and/or typed on the front and back of the purchase order are important to our Purchasing department.

About Us
How To...
Careers
Latest News

Download the free Adobe Reader.

Materials available on this Website in PDF format may require the free Adobe Reader to view. To download Adobe Reader for free from the Adobe Website, click here.