Critical thinking Case Study – Medicare Fraud and Abuse Report
Examine the legal and ethical implications of fraud and abuse with Medicare. Identify a real-world case of Medicare fraud and/or abuse. Write a 4-5 page report using readings, research, and knowledge of health law and ethics to analyze this case.
Your report should address the following substantive requirements:
Description of what occurred, who was affected, and why
Assess the case from the following perspectives:
Ethical – identify the ethical principles involved in this situation from the perspective of all those involved.
Legal – what are the legal implications and what laws or statutes were involved?
Provide two recommendations for how to manage this case from the perspective of the healthcare organization involved. What could have been done to prevent this situation?
Recommend next steps to manage this case.
Your report should meet the following structural requirements:
Be 4-5 pages in length, not including the cover or reference pages.
Be formatted according to the APA Requirements.
Provide support for your statements with in-text citations from a minimum of four (4) scholarly articles. Two (2) of these sources may be from the class readings, textbook, or lectures, but two (2) must be external. The CSU-Global Library is a good place to find these references.
Utilize the following headings to organize the content in your work.
Introduction
Assessment
Recommendations
Conclusion
Solution Preview
Introduction
Cases identifying with medical care fraud and abuse have turned out to be more widespread than earlier and this has prompted improvement of laws and statutes concerning this issue. A standout amongst the most well-known real world cases of medical care fraud and is that of Health Alliance of Greater Cincinnati and Christ Hospital kickback examination settlement. As clarified in an article composed by Rachael (2010), the two medicinal foundations consented to pay one hundred and eight million dollars to settle asserts that they disregarded the false claims act anti- kickback statute and the anti- kickback statute. The associations partook in medical fraud and abuse by unlawfully paying doctors in return for alluding cardiovascular patients to the Christ hospital.
(1,223 words)