Reference no: EM13816660
Assignment: Corporate Compliance
You are a corporate compliance officer for a hospital. You are also a feature writer for The Medical Reporter, an online health magazine. The editor asks you to write an 8-10 page feature story about the steps you should take when fraud and abuse cases are reported to a facility. This is very timely as you recently received a call on your "hotline" regarding a potential fraud and abuse issue. The caller indicated that Dr. Greedy was billing for services that had not been provided. You are in danger of losing reimbursement for Medicare and Medicaid programs if this behavior is not stopped. Your feature should address the ethical and moral components that healthcare providers and healthcare facilities face with fraud and abuse issues. Your research should include the following aspects:
How to conduct an investigation. It should include the following elements:
Reviewing the initial complaint: What are the items you should look for in a compliant to determine validity?
Notifying the appropriate upper management of the complaint unless they are implicated in the complaint: What are the steps to take to determine who is involved?
Obtaining additional information as necessary and developing a plan for the investigation: What other items are important to the investigation?
Conducting interviews with staff, residents and/or management: Delineate the types of questions to ask in the interview.
Determining if the allegations are substantiated or unsubstantiated: Identify criteria to determine if substantiated or unsubstantiated.
How to develop a correction action plan. The plan may suggest:
A recommendation for a subsequent audit or follow-up to the complaint and determination of when this is necessary.
A recommendation to refund any overpayments to federal government, insurance company or individual payer and when that may be the best course of action.
|
Salespeople create value in what two ways
: Salespeople play three primary roles. What are they? Salespeople create value in what two ways? Do customer relationships begin as transactional and move toward strategic partnerships
|
|
Changing economy and patient access
: In a response to the changing economy and patient access from the suburban areas to the city, Happy Trails has taken some measures to compete, become more attractive, and build on its long-term care for patients in the surrounding areas.
|
|
State structural configuration better suited to multiproduct
: Is another form of structural configuration better suited to multiproduct, multiservice companies. If not, is there a form of departmentalization for multiproduct, multiservice companies which would match somewhat the divisional structure configur..
|
|
Describe the leadership style
: Based on your reading, describe the leadership style that would best help this leadership team deal with their expanding employee, management, and warehouse base.
|
|
How to develop a correction action plan
: You are a corporate compliance officer for a hospital. You are also a feature writer for The Medical Reporter, an online health magazine. How to develop a correction action plan
|
|
What are the costs and benefits of bribery to a business
: What are the costs and benefits of bribery to a business? Is the FCPA unnecessarily harsh or do its provisions diapense the appropriate level of punishment?
|
|
Process for filling a job vacancy
: Research the process for filling a job vacancy and address the following: Discuss the sequence of activities that are involved in hiring a new employee.
|
|
Explain odd-even pricing and prestige pricing
: Identify an example of each of the following: odd-even pricing, prestige pricing, price bundling, and captive pricing
|
|
Assignment on social performance of organizations
: According to the textbook, the current world economy is increasingly becoming integrated and interdependent; as a result, the relationship between business and society is becoming more complex.
|