The foundation of all we do
Compliance overview

A commitment to accountability.

LaSalle is committed to promoting a culture of honesty and integrity in its business standards, in association with the delivery of health care through its provider network, and in compliance with healthcare program and payor requirements.

Our compliance policy

It is our policy to comply with all applicable federal and state laws and regulations mandated by the Centers for Medicare and Medicaid Services (CMS), the Office of the Inspector General (OIG), the California Department of Health Care Services (CA DHCS), the California Department of Managed Health Care (DMHC), and the Department of Justice (DOJ). LaSalle’s Compliance Program is designed to detect, prevent, and correct fraud, waste, and abuse as addressed in the False Claims Act and other non-compliant activities in healthcare.

All employees, executive leaders, temporary workers, and contracted providers and vendors are expected to conduct business to the highest ethical standards.

Details of our compliance program are outlined below.

Compliance topics

Code of Conduct

LaSalle’s Code of Conduct supports our Compliance Program and outlines expectations for ethical conduct. It is intended to complement (but not replace) existing policies and procedures. Where no existing policy addresses a particular subject, the Code serves as the applicable policy.

The Code establishes the following principles and standards:

  • LaSalle shall comply with all applicable laws and regulations
  • LaSalle shall conduct its affairs in accordance with the highest ethical standards and business practices
  • All LaSalle workforce members shall avoid conflicts of interest
  • LaSalle shall strive to attain the highest standards for all aspects of patient care
  • LaSalle shall provide equal opportunity and respect the dignity of all members, providers, and employees
  • LaSalle shall maintain appropriate levels of confidentiality for all information and documents entrusted to it

The Code is reviewed and updated annually, or more frequently as conditions, policies, or regulations require.

Download file

Code of Conduct

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Reporting & non-retaliation

All LaSalle employees and contracted providers and vendors are responsible for complying with the Code of Conduct and Compliance Program. It is the duty of every member of our network to immediately report any potential or suspected violations, health care fraud, security and privacy incidents, or other misconduct without fear of retaliation or reprisal.

Reports may be made to Human Resources, the Compliance Officer, the Information Security Officer, or through LaSalle’s Compliance Hotline, operated 24/7 by an independent third-party vendor:

Compliance Hotline: (855) 888-2226

(Callers may remain anonymous)

Additional reporting options are available through Lighthouse Syntrio:

Note: be sure to include the company name in emailed or faxed reports

Compliance concerns may also be reported directly to a supervisor, who is required to refer the matter promptly to the Compliance Officer.

All notifications and reports, whether external and internal, are maintained within LaSalle’s Case Management System (CMS). The CMS is only accessed by the LaSalle Compliance Officer and specific designated staff assigned by the Compliance Officer. 

What happens after you report

LaSalle’s Compliance Officer promptly reviews and thoroughly investigates all reported violations of the Code, policies and procedures, and applicable laws and regulations. All related information and documentation is maintained with the highest degree of confidentiality.

Where an investigation identifies non-compliance, the Compliance Officer will recommend remediation measures to Executive Leadership, the Compliance Committee, the Quality Improvement Committee, or other appropriate stakeholders to prevent recurrence.

Probable violations involving fraud, waste, and abuse by providers, members, or vendors will be reported to the appropriate federal or state law enforcement agency.

Disciplinary standards

Any person who actively or passively participates in, encourages, facilitates, or permits non-compliant behavior (including misconduct that impacts participation in government healthcare programs such as Medicare or Medicaid) or who fails to report suspected or actual violations, may be subject to disciplinary action.

Disciplinary action may include retraining, oral or written reprimands, suspension, or termination of employment or contract, as described in the Code of Conduct and LaSalle’s personnel policies. Additional remedial measures may also be taken as appropriate.

Required provider & vendor training

LaSalle requires all contracted providers and vendors to complete training in the following areas:

  • General Compliance
  • Fraud, Waste, and Abuse (FWA)
  • HIPAA
  • Cultural & Linguistics (C&L)
  • Model of Care (MOC)

Training resources are available through the links on our Provider Compliance Training page.

Questions may be directed to LSMA Management’s Compliance Department at compliance@lsmamso.com.