Non-Compliance Report and CCM Policies


CCM’s Compliance Program (see the CCM compliance manual 2020) is committed to maintaining compliance with applicable federal, state, and local laws, rules, and regulations as well as healthcare industry standards and ethical standards of business conduct.

Executives/Board of Directors/Employees/Interns/Vendors and/or Contracted Staff/Volunteers who have knowledge of actual or suspected violations of law or agency policy, operating procedures or conduct, which might reasonably constitute fraud, waste, abuse, corruption or misconduct must report what they know as soon as possible, to either their supervisor and the Compliance Officer.

Please complete the form below if you suspect any non-compliance.  Please note that the report is anonymous and confidential.  However, if you wish to be contacted regarding the outcome of the investigation please include an email address. If you do so, the report will not be anonymous.

Please be aware that the form below is intended for Medicaid non-compliance and HIPAA non-compliance report only. Complaint reported through this portal other than Medicaid non-compliance and HIPAA non-compliance will not be addressed. For any complaint against or feedback to staff or CCM, please download, complete and send the CCM Compliment and Complaint Form to or call Hanna Wang, Quality Assurance Manager at 718-802-0666 (ext. 229).

Please also feel free to contact Hanna Wang if you have any compliance questions or concerns.


CCM Privacy Policy


Compliance - anonymous complaint form
Area of alleged non-compliance
(select one) (required)
(select as many as apply) (required)
Program Site
(select as many as apply) (required)
Have you reported the alleged non-compliance to a manager? (required)
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