Fraud and Abuse Laws
Address (Answer) ALL questions in a minimum of 400, maximum 550 words
1. Consider the settlement in U.S. v. Halifax and the Corporate Integrity Agreement entered into by Halifax Hospital Medical Center, which addresses methods for preventing Anti-Kickback violations.
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1. What measures required by the Corporate Integrity Agreement do you believe will be most effective in preventing future violations?
2. Which, if any, do you think will be least effective or ineffective in preventing future Anti-kickback violations? Explain your reasoning.
1. What is a Medicaid Integrity Plan? Who is responsible for creating and maintaining it? What does it cover?
2. The Physician Self-Referral law (Stark law) prohibits physician referral to designated health services (DHS) in which the physician or family member has an ownership interest. As a health care administrator what could you do to monitor this?
3. The False Claims Act is often linked to billing problems such as upcoding, billing for non-medically necessary services, services not provided, unbundled services, etc. What billing strategies could you implement to lessen the likelihood for a False Claims Act problem?
Instructions: Please answer using your own words in a minimum of 400, maximum 550 words (2.5-3 paragraphs). Referenced with Three (3) peer-reviewed journal articles or qualified text publish within the past five years and follow APA Manual 6th or 7th editions scholarly writing guidelines. APA in-text Citation formatting is required. When writing replies, please provide your experiences, new ideas, add probing questions to engage readers and new literature on the topic to enhance the learning opportunity.
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