Governance and Fraud in Health Care Organizations – Legal and Ethical Responsibilities: False Claims Act

July 6, 2023July 6, 2023 Discipline: Nursing

Topic: False Claims Act

(FCA) 31 U.S.C Sections 3729-3733

Include a cover page and a list of references at the end of the paper in APA Format.  Paper will be double spaced and be 4-5 pages in 12 point New Times Roman font.
Outline:  Must use the headings from the outline below in your paper and the paper must be in narrative form not outline or bullet format.

1.    Name of the Law and or laws:  
State the official title of the federal and/or state law, the statute and section number.  Must be either a federal statute or state statute and you must cite both if applicable. Thus if there is both a federal and state law that covers your subject picked then you must cite both. Do not assume that there is just a federal and or state law. In most cases there is both a federal and state law. You must use the laws cited in this section throughout the rest of the paper.
  • Relevant federal and state statutes are all current and properly titled. Research represents a thorough canvass of the law and secondary sources.

2.  Management’s Financial Responsibilities:  

What are the health care organization’s responsibilities under this financial management statute you stated above? Provide a comprehensive discussion of three (3) specific responsibilities under the financial management statute. State specifically after each responsibility  where this responsibility is stated in the federal or state law.  Describe the appropriate behavior and expectation. Include the citations and source of documents describing the organization’s responsibilities. 

  • Demonstrated high degree of logic and reasoning when discussing the law and connecting to main points regarding three (3) financial responsibilities.  

3. Consequences for Ethical or Legal Breach:

Discuss in general the civil and criminal consequences from the law. Then identify from the news, three (3) specific case examples of health care organizations or health care providers found guilty of a legal or ethical breach relative to the False Claims Act you have cited in first part of paper. Identify the specific legal and/or ethical breach and the penalties assessed to the health service organizations and/or individuals found guilty of violating the law or ethics [provide citation of law].  At the end of each case, discuss in detail whether you agree or not with the decision and why. Bring in the facts of the case to support your comments. Students should use a minimum of three (3) documented specific examples retrieved from the internet. 

  • Student provided extensive original analysis of civil/criminal consequences, financial responsibilities and why agree/disagree with court’s decision.
  • Student has identified three (3) real life cases that are precedent, seminal, or not previously discussed in Discussion Board.

4. HCO Management’s remedial steps to reverse the non-compliance organizations:

Describe in detail three (3) specific management actions or remedial steps you would take to ensure the financial management in the health care organization meets or exceeds the federal law or state law relative to the requirements of the law you cited above. Discuss specifically how each of the three management actions specifically meets or exceeds the specific federal or state law you cited. Note: These actions may include specific uses of technology, procedures, human resource training, and other management tools.  However these action steps must be within the control of a manager. 

  • Student offers original contributions to the discussion of three (3) remedial management actions. Remedial management actions discussed are related to each other in interesting and creative ways with reference to research. 

5. Conclusion: Summary your findings above

  • Thought provoking or interesting conclusion that ties everything together and furthers the thesis of the paper.  

6. Reference List [APA Format]

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