Fraud and Abuse - Essay Example

Only on StudentShare

Extract of sample
Fraud and Abuse

This is essentially what I am being asked to do; I am being asked to pay "monthly bonuses" to the Central Park Medical Group in order to form a business arrangement in which patients of the Central Park Medical Group are sent to my establishment, Sundown Community Hospital. In addition, it seems that the board as well as myself are fully aware of the fact that 60% of the Central Park Medical Group patients are covered by government health coverage. This is obviously why the board is eager to seal this deal with the medical group.
The fact that this is a joint venture agreement makes some of the facts a bit subject to interpretation as the Board of Medical Directors has implemented certain rules depending on the state. Anti-kickback statutes specifically state that income that may surface from joint venture activities must be compensation for services rendered. The "bonuses" given to physicians in the joint venture agreement between my organization and the medical group in question is very clearly not for any purpose but as referral incentive.
The Medicare and Medicaid Protection Act of 1987 clearly state that the type of actions described by the board to me as the administrator would qualify as a federal offense punishable with fines of up to $25,000 as well as other possible sentencing. ...
Download paper


As the head administrator for Sundown Community Hospital, I have been directed by the board to enter into a joint venture agreement with Central Park medical group. I am aware that this medial group treats a patient population of which 60% are covered by Medicare…
Author : keiraledner

Related Essays

Computer Fraud
Finally, we present our views on how individual computer users and businesses can help in the successful implementation of various anti-fraud programs.
8 pages (2008 words) Essay
BHS 499 (Senior Capstone Project) Module 3 SLP
One major implication of health care fraud and abuse is the monetary loss due to e improper activities which endanger patient safety. The United States Attorneys' offices (USAOs) are held responsible for the civil and criminal prosecution of health care providers, professionals, and other specialized business agencies who engage with health care fraud and abuse. The US government has appropriated certain amount (DOJ, 2000) from the United States Treasury general fund and they in turn must appropriate the Account for transfer some to the federal Bureau of Investigation in order to carry out the...
2 pages (502 words) Essay
Elder Abuse in Nursing Homes
Some are even outright fraudulent.
19 pages (4769 words) Essay
ColumbiaHCA and the Medicare Fraud Scandal
My goal is to relate the case to the subject of Business Ethics and derive important lessons on how business should be conducted.
12 pages (3012 words) Essay
Medicaid Health Care Finance
Medical Science is still in its development stages as cures for diseases that were incurable are being developed. Such an example is of cancer, Hepatitis B and etc. These diseases were incurable some time ago but the advancement in medical sciences has enabled doctors to cure such diseases. Treatment for these diseases is not only available but is also done at cheap rates that are affordable, but still affordability has been a problem. Medical Science has experienced two major problems in the last decade. Number one is the affordability of treatment and medicines for people and secondly the...
3 pages (753 words) Essay
Financial Cost of Corporate Fraud in United States and Ethical Training of Employees
However, the study reveals that fraud training for employees and managers reduces the risk of fraud by 52% and 56% respectively (ACFE, 2009, p.37). Thus, ethical training may be employed as a control against fraud. However, this may not be adequate and other controls must be put in place for early detection of fraudulent activities.
2 pages (502 words) Essay
Healthcare fraud and abuses have showed an increasing growth and therefore effective functioning of healthcare programs requires cooperation and mutual understanding between healthcare professionals and patients. Violation of patient’s right endorses miscellaneous effects in the social scenario. Ethical principles in healthcare programs can reduce healthcare fraud and abuses. This paper seeks to explore the ethical principles that govern health care practices and in doing so the paper throws light on the fraud and abuse that prevail in the health care industry.
6 pages (1506 words) Essay
Got a tricky question? Receive an answer from students like you! Try us!