CASE STUDY
CASE STUDY Selection:
Select two similar enforcement cases using a search of the Office of Inspector General and/or Department of Justice website. Both cases should relate to a similar type of healthcare non-compliance. (For example: False Claims, HIPAA violations, Kickbacks, Excluded Providers, etc…)
Read the following:
1. Case 1: OIG-False Claims Case: https://www.justice.gov/usao-ks/pr/kansas-hospital-agrees-pay-250000-settle-false-claims-act-allegations
2. Case 2: HHS-HIPAA Case: https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/pagosasprings/index.html
3. https://www.youtube.com/watch?v=R65js82-SLk&feature=youtu.be
4. https://youtu.be/R3vAeH9XQQs
Assignment Instructions:
Use the two case studies do the following:
• Illustrate the MANY impacts of noncompliance and unethical behavior on each of the following: the health care organization, the insurance payers (government and or private), the health care professional and the health care patient
• Conclude by speculation what weaknesses, in the organization’s environment, that may have existed that allowed the behaviors to go unnoticed.
Format your paper and references according to APA style.
5. https://www.youtube.com/watch?v=onSCJs4e404&feature=youtu.be
6. https://youtu.be/ekZ77MPW-IU
7. https://youtu.be/s9znUYvVO4A
8. https://youtu.be/omnbNh6RNhs
9. https://youtu.be/y751i4QqP0g
10. https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/qualitymeasures/index
11. https://www.healthcare.gov/health-care-law-protections/
12. https://www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/nursing-homes
13. https://www.hhs.gov/answers/health-care/what-are-my-health-care-rights/index.html
