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Navitus Health Solutions, EpiphanyRx, and Lumicera Health Solutions (collectively “Navitus”) is committed to compliance with all applicable laws, regulations and contract requirements. In addition, we hold ourselves to the highest ethical standards on behalf of our clients and members. To help ensure we maintain our compliance and ethical standards, we work closely with our vendors and business partners.

Our vendors are business partners who are important to our success and play a critical role in servicing our members and clients, whether directly or indirectly. This Vendor Code of Conduct (Code) is provided to you as an easy way to communicate our expectations as your company fulfills the terms of the contract. This Code is a guide and does not include all possible activities. Please share with your employees and contact us if you have a question about an activity not included in this Code.

Compliance Obligations
Vendors are expected to have mechanisms to enable employees, including temporary employees, or affiliates of vendor to report non-compliance, violations of this code of conduct, or other grievances. Such methods should protect the individual reporter from retaliation and offer anonymity. Navitus has several methods for reporting including via confidential, toll-free hotline, email, or mail. All good-faith reporting is protected under the Navitus Non-Retaliation Policy. Vendor may distribute the Navitus toll free Compliance Hotline number which is 1-855-673-6503.

Vendor is expected to take all reasonable actions to address non-compliance and remediate, mitigate, and engage in corrective action to comply with laws and regulations, comply with Guiding Principles on Business and Human Rights, health and safety protections, labor laws, and environmental protections. Navitus reserves the right to audit Vendor where performance of services is dependent on such compliance.

Gifts and Business Gratuities
Navitus discourages you from providing any gifts, meals, entertainment or other business gratuities to Navitus employees, consultants or pharmacists. While we appreciate the occasional pen with your business name, items such as the following are not appropriate:

  • Gifts or entertainment of any kind to any Navitus staff during the selection, negotiation orpurchasing stages of a contractual arrangement.
  • Gifts or entertainment that could be perceived as a bribe, payoff or advantage.
  • Cash or cash-equivalents, such as checks, gift certificates/cards or stock.
  • Gifts or entertainment that violate the law.

Conflicts of Interest
Conflicts of interest between a vendor and Navitus staff (or the appearance of a conflict) should be avoided. When an actual, potential or perceived conflict of interest occurs, that conflict must be disclosed, in writing to Navitus.

  • While Navitus employees may occasionally have secondary employment, no Navitus employee member may work for a vendor that has a contractual relationship with Navitus.
  • No Navitus employee may participate on the board of a vendor with whom Navitus does business.
  • Navitus will not engage with an individual who has been employed by Navitus within the last 24 months and who has been assigned as Navitus’ representative by the Vendor for products, sales, negotiation, contracting, promotion or other activities where the former employee’s confidential and proprietary knowledge about Navitus is a component of that assignment.

Compliance with Laws
Vendors are expected to conduct their business activities in compliance with all applicable laws and regulations, including Medicare and Medicaid. Vendors are also expected to take appropriate action against any of its employees or subcontractors that have violated such laws.

Privacy and Security
State and Federal privacy laws, such as the requirements of the Health Insurance Portability and Accountability Act (HIPAA) require Navitus and its Vendors to maintain the privacy and security of patient information (PHI). If a vendor has access to Navitus PHI, the vendor is responsible for ensuring that all employees who provide services to Navitus are trained on HIPAA Privacy and Security Rules and is expected to provide an annual attestation that such training has been completed. In addition, if vendor uses or discloses PHI on behalf of Navitus, the vendor will be expected to enter into a Business Associate Agreement.

Employed or Contracted Persons
Navitus will not knowingly do business with any vendor if it is, or any of its officers, directors or employees are excluded, debarred or ineligible to participate in any Federal or State health care program. To ensure no exclusion exists, Navitus vendors must screen all employees (including temporary and contracted), officers and directors against Federal exclusion lists before hire or engagement and on monthly thereafter. These lists are the U.S. Department of Health and Human Services, Office of Inspector General List of Excluded Individuals and Entities (LEIE) and the General Services Administration's System for Awards Management (SAM). Vendors may be expected to provide an annual attestation that such exclusion screening has occurred.

Navitus will not knowingly do business with any vendor engaged in corruption, illegal sourcing or anti-boycott activity or involved in human trafficking, slavery, or child labor. Navitus expects a vendor to implement and enforce systems and controls to ensure that such abuses do not occur in staffing, in operations, in supply chains, with downstream entities or in relation to services to Navitus. This includes but is not limited prohibiting any requirement for employees, temporary workers, or contractors to pay fees or expenses to secure work with Vendor and prohibiting the retention of identity documents as a condition of working for Vendor.

Fraud, Waste and Abuse (FWA)
Vendors are expected to report any suspected or actual acts of FWA regardless of the source or possible participants. Navitus will investigate allegations of FWA and, where appropriate, will take corrective action, including civil or criminal action.

Vendor Compliance Training
Navitus requires all vendors, including vendor employees, to participate in and complete general compliance and FWA training. The vendor must document and provide an annual attestation that training has been completed. Training can be completed using the CMS free training modules located on the CMS MLN website. In addition to compliance and FWA training, Vendors and their employees who qualify as Business Associates must also complete annual privacy and security training. This training can be completed using the vendor’s training or by requesting a copy of the Navitus privacy and security training.

Vendor is obligated to comply with any additional regulatory or industry training requirements and maintain such evidence of training as needed by Navitus to represent the quality, knowledge, and/or regulatory awareness of the Vendor and its employees or contractors.

Business Record Retention
Navitus requires vendors to retain records related to services provided to Navitus for ten (10) years. These records must be made available to Navitus or a government auditor in accordance with applicable laws, regulations and contract terms. Visiting Navitus It is expected that any vendor who visits our campus additionally adheres to the Visitor Code of Conduct.

Visiting Navitus
It is expected that any vendor who visits our campus additionally adheres to the Visitor Code of Conduct.