Healthcare organization

 

Scenario
You work within a healthcare organiza!on as the director of quality, and your chief compliance officer has asked you to create
a memo to be distributed to the en!re organiza!on. They have asked that the memo focus on how an organiza!on can be#er
manage risk to the revenue cycle and healthcare reimbursement by examining ways to reduce fraud, waste, and abuse.
Direc!ons
Create a memo to assess how the following laws and regula!ons can help a healthcare organiza!on reduce fraud, waste, and
abuse and thereby manage risk to the revenue cycle and reimbursement. Also, recommend strategies and technology to help
an organiza!on abide by the laws and regula!ons. Refer to the following laws and regula!ons to guide your response:
False Claims Act
Physician Self-Referral Law
An!-Kickback Statute
An!-Trust Laws
You may refer to the “Ac!vity Reading” resource in the module resources sec!on to be#er understand how a memo is
structured. If you need wri!ng support, access the Online Wri!ng Center through the Academic Support module of your
course.
Specifically, you must address the following rubric criteria:
1. False Claims Act: Analyze the impact of the False Claims Act on the organiza!on’s reimbursement, coding, and
strategic planning. Consider the following ques!ons to guide your response:
What are the provisions of the False Claims Act?
What penal!es could an organiza!on face for viola!ng the Act?
2. Physician Self-Referral Law: Analyze the impact of the Physician Self-Referral Law on a healthcare organiza!on’s
reimbursement, revenue cycle, and strategic planning. Consider the following ques!ons to guide your response:
What are the features of the Physician Self-Referral Law?
How does this law help prevent fraud and abuse in healthcare?
3. An!-Kickback Statute: Analyze the impact of the An!-Kickback Statute on healthcare reimbursement and referrals.
Consider the following ques!ons to guide your response:
How is the An!-Kickback Statute different from the Physician Self-Referral Law?
What kind of financial penal!es would be a#racted by the viola!on of this statute?

Sample Solution

Although the climate was a motivational one, it was important that For the students to benefit from the iPad, they needed to be able to construct their learning socially. Resulting in the AT placing the students into specific groups as they were given a chance to construct knowledge through their interactions and engagements with others (Henderson and Yeow, 2012) and utilise the iPad to the highest level as student-produced digital video encourages active problem-based learning (Pellett et al, 2009) and higher -order thinking skills (Fu, 2013) creating challenge (Appendix 11) . The iPad was used to help students develop their skills through AfL (Appendix 11). The observing teacher wrote down on the observation sheet that ‘the iPad focuses the pupils on assessing their routine and making improvements’. The observing teacher then went on to say in a professional discussion that ‘’it was the best approach for the learning environment the students were in” and that it ‘’was clear to see that students had made progress due to being able to construct and assess learning in groups”. These comments highlight how well the iPad and the learning environment it created worked concerning pupil progress. It was evident to see the student’s social skills were developing as discussions between students were very informative with a clear aim of students wanting to develop their sequences which link back to the objectives of the lesson (Appendix 3) and the progress teaching standard(Appendix 11).

Moreover, it was evident that students were being challenged and the pitch of the lesson was right (Appendix 11) as, during students’ discussions, most of the students were thoroughly conversating to a high level. During this point, the AT and the observing teacher discussed the situation with each other where the observing teacher highlighted that ‘the use of the iPad was developing their cognitive and social skills at this point because they were figuring out how to improve their physical ability through social situations. In Contrary, the observing teacher specified in the same the lesson ‘’students have more of an understanding of the keywords and what they needed to improve, resulting in them showcasing higher level thinking skills, asking

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