Compliance Program

As the local health plan of choice, the mission of the Health Plan of San Joaquin / Mountain Valley Health Plan (“Health Plan”) Compliance Program is to support our partners with respect, integrity and clarity. Our vision is to be a trusted partner in Compliance and Service. The program establishes and enforces compliance with ethical standards, Health Plan policies and procedures (P&P), contract requirements and applicable federal and state laws and regulations. To review our Compliance Program Plan, please click HERE.

Health Plan has established, implemented, and provides effective training and education for all network providers and their staff.

Compliance Policies & Procedures

Name English Spanish Khmer Vietnamese
CMP01 – Response and Prevention of Compliance Violations Download Download Download Download
CMP01 – Response and Prevention of Compliance Violations - Large Print Download Download Download Download
CMP02 Records Management and Retention Download Download Download Download
CMP02 Records Management and Retention - Large Print Download Download Download Download
CMP03 – Code of Conduct and Ethics Download Download Download Download
CMP03 – Code of Conduct and Ethics - Large Print Download Download Download Download
CMP04 – Civil Rights Act Download Download Download Download
CMP04 – Civil Rights Act - Large Print Download Download Download Download
CMP12 – Non-Retaliation for Reporting Violations Download Download Download Download
CMP12 – Non-Retaliation for Reporting Violations - Large Print Download Download Download Download
CMP18 – Public Records Act Requests Download Download Download Download
CMP18 – Public Records Act Requests - Large Print Download Download Download Download
CMP23 – Conflict of Interest Download Download Download Download
CMP23 – Conflict of Interest - Large Print Download Download Download Download

Fraud, Waste, and Abuse/Privacy (HIPAA) Policies & Procedures

Name English Spanish Khmer Vietnamese
CMP05 – Fraud Waste and Abuse Download Download Download Download
CMP05 – Fraud Waste and Abuse - Large Print Download Download Download Download
HPA03 – Designation of Privacy Officer and Security Officer Download Download Download Download
HPA03 – Designation of Privacy Officer and Security Officer - Large Print Download Download Download Download
HPA07 Reporting and Mitigating Suspected Privacy & Security Incidents & Breaches Download Download Download Download
HPA07 Reporting and Mitigating Suspected Privacy & Security Incidents & Breaches - Large Print Download Download Download Download
HPA10 Whistleblowers and Workforce Crime Victims Download Download Download Download
HPA10 Whistleblowers and Workforce Crime Victims - Large Print Download Download Download Download
HPA11 – Changes in HIPAA Law Download Download Download Download
HPA11 – Changes in HIPAA Law - Large Print Download Download Download Download
HPA16 – Notice of Privacy Practices Download Download Download Download
HPA16 – Notice of Privacy Practices - Large Print Download Download Download Download
HPA21 – Member Rights for Use and Disclosure of Protected Health Information (PHI) Download Download Download Download
HPA21 – Member Rights for Use and Disclosure of Protected Health Information (PHI) - Large Print Download Download Download Download
HPA34 – Use of Member PHI, PII Download Download Download Download
HPA34 – Use of Member PHI, PII - Large Print Download Download Download Download
HPA42 – Safeguarding Protected Health Information Personally Identifiable Information Download Download Download Download
HPA43 – Policy Member Rights for Protected Health Information Download Download Download Download
HPA43 – Policy Member Rights for Protected Health Information - Large Print Download Download Download Download
HPA44 – Sensitive Services Download Download Download Download
HPA44 – Sensitive Services - Large Print Download Download Download Download

Posted on September 8th, 2025 and last modified on September 17th, 2025.

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