Compliance Information
At the Alliance, we follow strict rules to help keep our members safe. This is part of our mission to provide accessible, quality health care and our vision of healthy people and healthy communities.
We take important steps to protect member information, run our programs honestly, follow the laws and regulations that shape health care. Below, you can learn more about how we stay compliant and how these efforts help keep our members and communities safe.
Information about the Alliance’s plans for quality improvement and health equity, our code of conduct and county board meetings. Learn more.
Information about our code of conduct and policies and standards that apply to our network. Learn more.
Resources for First Tier, Downstream and Related Entities.
A First Tier Entity is a company or group that has a direct contract with a Medicare Advantage or Part D plan to provide services to members.
A Downstream Entity is a company or group that has a contract with a First Tier Entity (or with another downstream group) to help provide those Medicare services. These agreements continue all the way down to the providers who deliver the care or administrative work.
A Related Entity is a company that is connected to a Medicare Advantage or Part D plan through shared ownership or control.
Information and resources for Application Developers. Learn more.
The Final Rule requires plans and issuers to display in-network provider rates and historical out-of-network allowed amounts. Learn more.
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