Healthcare

Question 1.

The Stark Law intends to prevent and detect kickbacks in the delivery of health care. From the readings and independent research, find two specific real life examples of how kickback arrangements would violate the Stark Law and discuss with your colleagues how the kickback arrangements could violate trust between provider organizations and patients. Consider using the terms transparency, patient choice, and informed consent. Read the background articles but this discussion will take research beyond the above articles. Provide citation of authority to support your initial response to conference questions. Peers are expected to demonstrate critical thinking in their questions related to the classmates’ descriptions. Initial response to discussion topic must be no later than midnight Thursday and then you must substantively respond to at least 2 classmate submissions no later than 6pm Sunday. See Discussion Requirements in Discussion topic entitled “Discussion Expectations and Grading” No duplication. Redundant primary posts will not be graded. Must adhere to grading rubric for discussions.

Background sites to read

http://www.cms.gov/ [CMS]
http://oig.hhs.gov/compliance/provider-compliance-training/files/StarkandAKSChartHandout508.pdf
http://www.justice.gov/civil/docs_forms/C-FRAUDS_FCA_Primer.pdf[breakdown of The False Claims Act]
The Stark Truth about the Stark law Part I, http://www.aafp.org/fpm/2003/1100/p27.html

http://www.policyarchive.org/handle/10207/6087[SCHIP]
http://www.cms.gov/ [CMS]
http://www.justice.gov/civil/docs_forms/C-FRAUDS_FCA_Primer.pdf [breakdown of The False Claims Act]
The Stark Truth about the Stark law Part I http://www.aafp.org/fpm/2003/1100/p27.html
http://www.csrees.usda.gov/business/awards/ombcirculars.html [OMB circulars are an essential reference or “how to” legal guide for any organization receiving federal grant dollars or state flow through dollars.]
http://www.familiesusa.org/assets/pdfs/SCHIP-101.pdf [SCHIP]
http://www.crowell.com/documents/docassocfktype_articles_919.pdf [Deficit Reduction Act]

Question 2.
The False Claims Act is a federal law that addresses fraud. Defrauding the U.S. Government, specifically Centers for Medicare and Medicaid Services has consequences. From the readings and from the CMS website, discuss with your colleagues 1. two specific real life examples of a breach of the False Claims Act by a health-related organization, found on the internet or in the print media. Remember, organizations are made up of individuals. 2. In addition discuss whether health care organizations are properly equipped to ensure compliance and minimize exposure risks. If not why not?
Background sites to read

http://www.cms.gov/ [CMS]
http://oig.hhs.gov/compliance/provider-compliance-training/files/StarkandAKSChartHandout508.pdf
http://www.justice.gov/civil/docs_forms/C-FRAUDS_FCA_Primer.pdf [breakdown of The False Claims Act]
Brown, J. (2008). Develop a policy for amended records. Journal of Health Care compliance, January-February, 37- 38. [must use UMUC library]

Mekel, M. (2012). The Health Care Quality Improvement Act of 1986 Meets the Era of Health Care Reform: Continuing Themes and Common Threads. Journal of Legal Medicine, (33), 106. [must use UMUC library]
http://www.policyarchive.org/handle/10207/6087[SCHIP]
http://www.crowell.com/documents/docassocfktype_articles_919.pdf [Deficit Reduction Act]

 

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