Project #75808 - Goverance and Fraud in Health Care Organizations - Legal and Ethical Responsibilities

WEEK # 3 topic

The theme this week is responsibility in health care organizations. You will become familiar with the legal framework for these responsibilities and the penalties for violations, including:

*       The False Claims Act (1986 amendments)

*       The “Anti-kickback Statute” (1972 and subsequent updates)

*       Ethics in Patient Referrals Act of 1989 (inclusive of “Stark laws”)

*       falsification of medical records; criminal prosecution

*       Health Care Quality Improvement Act of 1986 (also called Health Care Anti-trust)

 

*       federal grant accounting principles (OMB circulars)

 

  • From the topics covered in Weeks 3-4, select one law 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.
  • The paper is to be written in clear, concise narrative. All sections in the outline for paper are required. The majority of the paper should be devoted to two sections:  a) The three (3) case examples and penalties of those found guilty; and b) the three (3) remedial steps involving management intervention to reverse the non-compliance in organizations such as these.

Outline must use the underlined headings from the outline below in your paper and the paper must be in narrative form not outline or bullet format. -2pts from 12.5pts paper is worth if underlined headings not used in your paper. 

1.  Name of the Law or Laws:  

Indicate the official title of the federal and/or state law, the statute and section number.  Must be either a federal statute      or state statute or 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]

2.  Management’s financial responsibility and consequences of a violation: 

What is the health care organization’s responsibility under this financial management statute? Describe the appropriate behavior and expectation. What are the consequences of a violation? Contrast the correct behavior with financial management behavior violating the law.  Include the citations and source of documents describing the organization’s responsibility. 

3. Consequences for Ethical or Legal Breach:

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. 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].  Do you agree with the result in each case? If so why and if not why not?  Use a minimum of three (3) documented specific examples retrieved from the print media. 

4. Management’s remedial steps to reverse the non-compliance organizations:

Describe three (3) specific management actions or remedial steps to ensure the financial management in the health care organization meets or exceeds federal law or state law. Discuss how each of the three management actions specifically meets or exceeds specific federal or state law. Be specific as to how exactly it meets or exceeds specific federal or state law. Use information provided in class such as the governance structure and standardized procedure development. 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 your findings above

 

6. Reference List [APA Format]

Subject Law
Due By (Pacific Time) 07/10/2015 12:00 am
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