VENTEGRA ANNOUNCES IT IS FIRST TO EARN CAA CERTIFICATION FROM HPFID'S COMPLIANCE PROGRAM DESIGNED TO MEET THE FIDUCIARY COMPLIANCE REQUIREMENTS OF THE CONSOLIDATED APPROPRIATIONS ACT
Ventegra is the first healthcare company in the pharmacy benefits space to be awarded HPfid CAA certification–Validates Ventegra's level of compliance and due diligence to meet CAA 2021 fiduciary requirements
GLENDALE, CA and OMAHA, NE–Ventegra, Inc., a Medical Benefit Manager (MBM) that delivers innovative, cost-efficient pharmaceutical and healthcare solutions to payors, providers, and members, announces it is the first to earn 2024 certification from HPfid's newly launched program that demonstrates that the awardees comply with the fiduciary requirements of the Consolidated Appropriations Act, 2021 (CAA).
The Consolidated Appropriations Act, 2021 (CAA) established protections for consumers related to surprise billing and transparency in health care.
This recognition by HPfid provides an important validation by an independent third party of Ventegra's unique business model and Ventegra's 20-year strong commitment to truth and integrity. HPfid is a CAA Compliance SaaS platform that helps employers comply with the Consolidated Appropriations Act, 2021 (CAA).
Robert T. Taketomo, Pharm.D., MBA, President/CEO, enthuses, "Ventegra is honored to be the first healthcare company in the pharmacy benefits space to be awarded this CAA certification. This further solidifies what our clients have always known about the transparency and integrity with which we conduct business."
The HPfid CAA certification program was developed to help purchasers of healthcare identify those entities who are compliant with the applicable provisions of the Consolidated Appropriations Act while also providing guidance to industry of what is required for compliance with CAA.
Underscoring the significance of this distinction, Dr. Taketomo says, "With all of the challenges coming to light about how pharmacy benefits are administered under a traditional Pharmacy Benefit Manager (PBM), this CAA certification validates our Ventegra Medical Benefit Manager (MBM) business model and how we manage prescription benefit programs with a high degree of integrity."
Dr. Taketomo further affirms, "This certification underscores Ventegra's unique societal perspective on healthcare as we continue our transition into a nonprofit entity. Our stakeholders and the community we serve can be assured that they will continue to receive the right balance of access to medications, quality of care and cost. It is a difficult balance to achieve that is a core strength of the Ventegra MBM business model."
Tony Sorrentino, JD, CPA, Chief Compliance Officer for HPfid, says, "The HPfid CAA certification program incorporates all of the experience of our team to distill the critical elements of CAA down to a single designation."
Sorrentino explains, "A C-suite or HR executive can be confident that using an HPfid CAA certified entity for their healthcare benefits is proof of transparency in agreements, fees, and reporting in compliance with CAA in managing their ERISA health plan."
In addition, a key benefit of the CAA certification program is its guidance to industry of the requirements necessary to be compliant with the appropriate provisions of the CAA. Any entity applying for certification would get a scorecard of their level of CAA compliance, and obtain an understanding of any requirements necessary to attain CAA certification from the HPfid program.
Ventegra remains one of the few independent entities in the market that directly contracts with manufacturers and passes on such discounts directly to clients. It is also the only B-Lab Certified California Benefit Corporation administering pharmacy and medical benefit programs under the MBM class-of-trade. To further its mission to provide more cost-effective healthcare to the communities served, Ventegra, Inc. is in the process of transitioning its business to Ventegra Foundation, a California Nonprofit Public Benefit Corporation.
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About Ventegra, Inc.
Ventegra, Inc. is the legacy Ventegra that is dedicated to servicing Ventegra Foundation. A complex transition process has begun, and over time, Ventegra, Inc.'s mission will be fully assumed by Ventegra Foundation. www.ventegra.org
About Ventegra Foundation
Ventegra Foundation is a California Nonprofit Public Benefit Corporation. Its mission is to establish new channels for delivering better efficiencies and more cost-effective healthcare for the community that is served. Ventegra Foundation is expected to be fully operational by June 30, 2024. www.ventegra.org
About Health Plan Fiduciary Guides
HPfid leverages its unique expertise in healthcare transparency and fiduciary compliance supported by an ERISA attorney, professor, and former advisor to help employers become proactive purchasers of healthcare. HPfid helps employers and advisors navigate the hidden fiduciary risks of buying health plans and build strategies to protect assets and fiduciaries. For information contact Tony Sorrentino at info@HPfid.com, www.HPfid.com.
Our drug list and formularies are designed to provide our clients with a choice of pharmacy products that meet all of the essential clinical conditions while addressing economic needs, and providing quality of care, affordability and choice.
Ventegra was founded to create balance between profitability and affordable patient care in an industry burdened by misplaced priorities. Our team applies our core values of integrity and transparency to create new healthcare delivery channels that are more consolidated and efficient. We channel our resources to positively impact the lives of others and create value for society as a whole.
Policies
HIPAA Compliance Policy
Ventegra has adopted a General HIPAA Compliance Policy in order to comply with the Health Insurance Portability and Accountability Act (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical Health (“HITECH”) Act of 2009 (Title XIII of division A and Title IV of division B of the American Recovery and Reinvestment Act “ARRA”) and the HIPAA Omnibus Final Rule (Effective Date: March 26, 2013). We acknowledge that full compliance with the HIPAA Final Rule is required by or before September 23, 2013.
Ventegra hereby acknowledges our duty and responsibility to protect the privacy and security of Individually Identifiable Health Information (“IIHI”) generally, and Protected Health Information (“PHI”) as defined in the HIPAA Regulations, under the regulations implementing HIPAA, other federal and state laws protecting the confidentiality of personal information, and under principles of general and professional ethics. We also acknowledge our duty and responsibility to support and facilitate the timely and unimpeded flow of health information for lawful and appropriate purposes.
This policy governs general HIPAA Compliance for Ventegra. All personnel of Ventegra must comply with this policy. Demonstrated competence in the requirements of this policy is an important part of the responsibilities of every member of our workforce. Officers, employees, Business Associates, contractors, affected vendors, temporary workers, and volunteers must read, understand, and comply with this policy in full and at all times.
Privacy Notice
Effective Date: March 1, 2021
This privacy notice discloses the privacy practices for this site. This privacy notice applies solely to information collected by this website, except where stated otherwise. It will notify you of the following:
What information we collect;
With whom it is shared;
How it can be corrected;
How it is secured;
How policy changes will be communicated; and
How to address concerns over misuse of personal data.
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Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.
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You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number provided on our website:
See what data we have about you, if any.
Change/correct any data we have about you.
Have us delete any data we have about you.
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Wherever we collect sensitive information (such as credit card data), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a closed lock icon at the bottom of your web browser, or looking for "https" at the beginning of the address of the web page.
While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (e.g., billing or customer service) are granted access to personally identifiable information. The computers/servers on which we store personally identifiable information are kept in a secure environment.
Notification of Changes
Whenever material changes are made to this privacy notice updates will be reflected here on our website.
Other Provisions as Required by Law
Numerous other provisions and/or practices may be required as a result of laws, international treaties, or industry practices. It is up to you to determine what additional practices must be followed and/or what additional disclosures are required. Please take special notice of the California Online Privacy Protection Act (CalOPPA), which is frequently amended and now includes a disclosure requirement for “Do Not Track” signals.
If you feel that we are not abiding by this privacy policy, you should contact us immediately via telephone at 858-551-8111 or privacyandsecurity@ventegra.org.
Fraud, Waste & Abuse
Part of our efforts to improve the healthcare system, Ventegra is committed to detecting, preventing and correcting fraud, waste and abuse.
What are Fraud, Waste, and Abuse?
FRAUD is generally defined as knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program. (18 U.S.C. § 1347)
WASTE is overutilization of services or other practices that, directly or indirectly, result in unnecessary costs to the health care system, including the Medicare and Medicaid programs. It is not generally considered to be caused by criminally negligent actions, but by the misuse of resources.
ABUSE includes any action(s) that may, directly or indirectly, result in one or more of the following:
Unnecessary costs to the health care system, including the Medicare and Medicaid programs
Improper payment for services
Payment for services that fail to meet professionally recognized standards of care
Services that are medically unnecessary
Abuse involves payment for items or services when there is no legal entitlement to that payment.
How to Report Fraud, Waste, and Abuse
If you suspect fraud, waste, or abuse in the healthcare system, please report it. To report suspected fraud, waste, or abuse, you can contact Ventegra:
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Ventegra, Inc.
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