Compliance

Overview

Highmark Wholecare Medicare Assured Medicare Compliance Program is designed to prevent, detect and correct Medicare Part C and Part D program non-compliance as well as Fraud, Waste and Abuse (FWA).

All parties, including Highmark Wholecare employees, governing body, first tier entities, downstream entities, related entities, and members involved with Highmark Wholecare Medicare Assured must comply with all applicable federal and state laws and regulations.




This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 27 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

Copyright 2022 by Highmark WholecareSM