Featherfall Medical Center: A Case Study

The ethical committee should intervene to determine the ethical responsibilities of the medical and administrative staff. The people involved should be held accountable and give them the opportunity to communicate the patients about the medical

In the health care business, there are certain standards and laws that have been put in place to protect our patients and their personal health information. When a health care facility fails to protect their patient’s confidential information, the US Government may get involved and facilities may be forced to pay huge sums of money in fines, and risk damaging their reputation.

Healthcare technology has grown and evolved over time. With the conversion to electronic medical records and the creation of social media just to name a few, ensuring patient privacy is of the utmost importance for healthcare facilities in this day and age. In order for an organization to avoid hefty fines, it is imperative that a healthcare administrator maintains compliance with the standards and regulations associated with the Health Insurance Portability and Accountability Act (HIPAA). This paper will provide a summary

Title II of HIPAA covers two main areas: preventing healthcare fraud and abuse, and a broad series of rules under the framework of administrative simplification. The first area is not of significant interest to most healthcare workers. It defines numerous offenses relating to healthcare, and authorizes several programs to attempt to find and control fraud and abuse. Nurses should be aware of the proper procedures for reporting fraud and abuse at their facility. The second portion of Title II—administrative simplification—however, contains five separate rules, most of which have already had a significant impact on virtually everyone working in American health care, including all those working in any way with health information concerning

Regulation placed upon the healthcare system only seek to improve safety and security of the patients we care for. The enactment of the Health Insurance Portability and Accountability Act (HIPPA) and the enactment of Meaningful Use Act the United States government has set strict regulations on the security of health information and has allotted for stricter penalties for non-compliance. The advancement of electronic health record (EHR) systems has brought greater fluidity and compliance with healthcare but has also brought greater security risk of protected information. In order to ensure compliance with government standards organizations must adapt

During this research, there has been a collection of data that had been connected to the instances of HIPAA violations within the United States. There are various cases that have been reported through patients and employees where very personal medical information has been exposed unlawfully for personal gain. These cases have not only put a company at reputational risk. But these cases can also place a patient and or healthcare company in a terrible financial stipulation. This thesis will include a series of charts and tables that describe the fluctuation of such cases involving different examples of HIPAA violations. Not only will there be data of these instances but there will be illustrations of how both patients and healthcare employees exemplify HIPAA violations. These cases will be verified from an external and internal evaluation. Suggestive protocol will be demonstrated to guide one along to ensure the possibility of another case of HIPAA violation is prevented. Protocols and examples are being credited by diverse information.

The purpose of this assignment is to review the factual content of and critically reflect upon the legal compliance considerations of eight major areas including, the Joint Commission, HIPAA/HITECH, Health Finances, Revenue Cycles, Medicare Recovery Audit Contractors, OIG work plan, OIG Corporate Integrity Agreement (CIA), the False Claims Act, and compliance and Provider Self Disclosure Protocol. These key elements have been provided by the GRC software Compliance 360 webpage.

Jones Regional Medical Center is a huge academic health center with 900 beds and are known for its research and teaching hospitals. Additionally, the IT staff at Jones supports 300 applications and 12,000 workstations. The center uses Technology Med (TechMed) for their admitting system. The system includes registration, inpatient charge, payment entry, master patient index, admission, hospital billing, and more. The TechMed system has been accessible since 1998; Jones is beginning to plan a replacement of this systems because of the fragility of the software (Wager, 2013).

According to the Federal Bureau of Investigation (FBI) “health care fraud costs the country an estimated $80 billion dollars a year” ("Health Care Fraud," n.d., p. 1). Because health care costs continue to rise more rapidly than the rate of inflation the threat of health care fraud continues to rise. The Affordable Health Care Act has put new policies in place to identify and stop health care fraud. The FBI along with other government, insurance, and public agencies have joined together to combat fraud at every level. New rules in identifying, investigating, and prosecuting fraud before payments are made to medical providers could save billions of

Plaintiff, OSCEOLA SC, LLC, a Florida Limited Liability Company d/b/a St. Cloud Regional Medical Center, (“Hospital”) by and through its undersigned counsel, sues Defendant, Rafael Fleites, M.D. (“Physician”), and alleges:

Attempts to stop fraud were enhanced under Public Law 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The purpose was to improve the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the efficiency and effectiveness of the health care system. This public law encouraged the development of a health information system through standards and requirements for the electronic transmission of certain health information (aspe.hhs.go). The Act established a program to take action against fraud committed against public and private health plans. The legislation required the establishment of a national Health Care Fraud and Abuse Control Program (HCFAC), under the joint direction of the Attorney General and the Secretary of the Department of Health and Human Services (HHS) acting through the Department 's Inspector General (HHS.gov). The HCFAC program is designed to coordinate Federal, State and local law enforcement activities with respect to health care fraud and abuse. The Act requires HHS and Department of Justice (DOJ) detail in an Annual Report the amounts deposited and appropriated to the Medicare Trust Fund, and the source of such deposits. (HHS.gov) I will summarize the impact of these laws as it pertains to how they are impacting the healthcare delivery system. (HHS.gov)

Tulsa Memorial Hospital (TMH) is one of the nine acute care hospitals that serves in the general population area. Historically, it has been highly profitable due to its well-appointed facilities, excellent medical staff, good-standing reputation for quality care and its ability to give individual attention for each of its patients. The hospital, in addition to its inpatient services, operates an emergency department and an urgent care center located two miles from the hospital across the street from a major shopping mall.

Although Congress has used several anti-fraud measures to protect the federal government health care programs, the False Claims Act of 1986 has become the main weapon that government prosecutors use against perpetrators of health care fraud. Designed to prevent fraud and other abuses in federal government programs, the False Claims Act has been the primary statute the government has used in its fight against health care fraud. However, government prosecutors do not rely on one statute in their prosecution of alleged cases of health care fraud. Instead, they rely on a combination of statutes, but the False Claims Act has emerged as the main statutory weapon.

I can only apologize for the lack of not getting my homework assignments completed. Please know that I started in on C2 - DQ and even helping out a classmate Ms. Carol at the lab center to get started. The reason for this email is to ask you it there was any way possible that I could finish this assignment, honestly I have been so sick and so exalted from this flu, are that’s what I was told at the Eagles Health Clinic that Wednesday I missed yours and another class that day. Now that it’s gone into another week and continuing with the high fever and cold and hot sweats and the only way that I been able to control the pain is by taking pain reliever, yuk! Being that it’s been over 3 weeks now, knowing the flu doesn’t go that long, you

The department of Health and Human Services protects and guides the health and well being of individuals here in America (Thacker, 2014). They fulfill these duties providing Americans with adequate and efficient health and human services and monitoring services designed to increase the efficiency of care in the health system (Thacker, 2014). One of the services being monitored by the department of Health and Human Services is the electronic health record system, which carries private and vital information of patient’s health record enabling all eligible participating health workers access to these records (Thacker, 2014). A breach of the protective health information of patients in a health organization creates chaos as these are against the health insurance portability and accountability (HIPAA) law (Thacker, 2014). Hence, measure will have to be put in place to determine what caused the breach and how to rectify it to ensure the breach never happens again (Thacker, 2014).