Hometown Health Administrative Guidelines | Page 3

The Mental Health Parity and Addiction Equity Act ( MHPAEA ) ................................................................. 88 Provider Regulatory Requirements Senior Care Plus .................................................................................. 90 Compliance Program ................................................................................................................................... 92
Health Insurance Portability and Accountability Act of 1996 ( HIPAA ) and the Health Information Technology for Economic and Clinical Health ( HITECH ) Act ....................................................................... 93
Compliance for Electronic Data Transmissions ........................................................................................... 95 Provider Medical Records ........................................................................................................................... 96 Provider Employment of Sanctioned Individuals ........................................................................................ 97 Fraud , Waste & Abuse Program .................................................................................................................. 98 Hometown Health Plan ( HMO ) Member Rights and Responsibilities ...................................................... 104 Hometown Health Plan ( EPO ) Member Rights and Responsibilities ........................................................ 108 Hometown Health Providers ( PPO ) Member Rights and Responsibilities ................................................ 112 Senior Care Plus HMO Member Rights and Responsibilities .................................................................... 116