Governance and Fraud in Health Care Organizations – Legal and Ethical Responsibilities
From the list below, choose one topic related to financial management in health care organizations. Include a cover page and a list of references at the end of the paper in APA Format. Paper will be double spaced and be 4-5 pages in 12 point New Times Roman font.
TOPICS
- False Claims Act
- Physician Self-Referral Act (Stark Law)
- Anti-kickback Statute
- Civil Monetary Penalties Law
- Exclusion Authorities
- Tax Exemption (Non-profit Hospitals)
- Anti-trust & Accountable Care Organizations
- Deficit Reduction Act
The assignment is to be written in a clear, concise narrative. All sections in the outline for Assignment #2 are required.
Outline: Must use the headings from the outline below in your paper and the paper must be in a narrative form not outline or bullet format. A penalty will be deducted from the paper if underlined headings are not used in your paper.
1. Name of the Law and or laws:
State the official title of the federal and/or state law, the statute, and section number. Must be either a federal statute or state statute and you must cite both if applicable. Thus if there is both a federal and state law that covers your subject picked then you must cite both. Do not assume that there is just a federal and or state law. In most cases, there is both federal and state law. You must use the laws cited in this section throughout the rest of the paper.
2. Management’s Financial Responsibilities:
What are the health care organization’s responsibilities under this financial management statute you stated above? Provide a comprehensive discussion of three (3) specific responsibilities under the financial management statute. State specifically after each responsibility where this responsibility is stated in the federal or state law. Describe the appropriate behavior and expectation. Include the citations and source of documents describing the organization’s responsibilities.
- Consequences for Ethical or Legal Breach:
Discuss in general the civil and criminal consequences of the law. Then identify from the news, three (3) specific case examples of health care organizations or health care providers found guilty of a legal or ethical breach relative to the law you have cited in the first part of the paper. Identify the specific legal and/or ethical breach and the penalties assessed to the health service organizations and/or individuals found guilty of violating the law or ethics [provide citation of law]. At the end of each case, discuss in detail whether you agree or not with the decision and why. Bring in the facts of the case to support your comments. Students should use a minimum of three (3) documented specific examples retrieved from the print media.
- HCO Management’s remedial steps to reverse the non-compliance organizations:
Describe in detail three (3) specific management actions or remedial steps you would take to ensure the financial management in the health care organization meets or exceeds the federal law or state law relative to the requirements of the law you cited above. Discuss specifically how each of the three management actions specifically meets or exceeds the specific federal or state law you cited. Note: These actions may include specific uses of technology, procedures, human resource training, and other management tools. However, these action steps must be within the control of a manager.
5. Conclusion: Summary of your findings above
- Reference List [APA Format]
Assigned reading materials:
- Chassin, M. R. (2020). The Joint Commission Code of Conduct. https://www.jointcommission.org/-/media/tjc/documents/about-us/code-of-conduct-manual-121520-final.pdf
- Storey, J., & Buchanan, D. (2008). Healthcare governance and organizational barriers to learning from mistakes. Journal of Health Organization and Management, 22(6), 642-51. doi:http://dx.doi.org.ezproxy.umgc.edu/10.1108/14777260810916605. http://ezproxy.umgc.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsemr&AN=edsemr.10.1108.14777260810916605&site=eds-live&scope=site
- Hamilton, J., F.A.C.H.E., & Sauders, K. J. (2018). How systematic compliance practices can address regulatory and risk issues in healthcare. Frontiers of Health Services Management, 34(4), 26-31. doi:http://dx.doi.org.ezproxy.umgc.edu/10.1097/HAP.0000000000000034 http://ezproxy.umgc.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118225078&site=eds-live&scope=site
- Keckley, P. H., PhD. (2019). Price transparency: Realities and implications. Healthcare Executive, 34(6), 38-41. http://ezproxy.umgc.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139713246&site=eds-live&scope=site
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