Identify and apply ethical principles to the management and delivery of health care

Identify and apply ethical principles to the management and delivery of health care

Assignment #2: Goverance and Fraud in Health Care Organizations – Legal and Ethical Responsibilities

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Course Objective for Assignment: Identify and apply ethical principles to the management and delivery of health care. Recommend structures and processes to manage compliance and to address ethical concerns in health care organizations. From the list below, choose one topic related to financial management in health care organizations. 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. TOPICS False Claims Act Physician Self-Referral Act (Stark Law) Anti-kickback Statute Civil Monetary Penalties Law Exclusion Authorities Tax Exemption (Non-profit Hospitals) Anti-trust & Accountable Care Organizations   Deficit Reduction Act The assignment is to be written in clear, concise narrative. All sections in the outline for Assignment #2 are required. 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. A penalty will be deducted from paper if underlined headings not used in your paper.  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. 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.  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 law 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 print media.  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.  5. Conclusion: Summary your findings above 6. Reference List [APA Format]  The paper must be: Late penalties: See Course Syllabus. Be sure and use the underlined headings found in the outline below in your paper. Paper must be in narrative format not outline or bullets.  Double spaced and be 4-5 pages in 12 point New Times Roman font. Include a cover page [not counted as a page] which should have student name and title of your paper [Provide a short name for the legal responsibility the specific health care organization has for one type of patient right in a specific setting ]  A the end of the paper a list of references in APA Format [not counted as a page]     Be prepared using word-processing software and saved with a .doc, .docx, or .rtf extension. No pdf. Be uploaded to your Assignments Folder by 11:59 p.m. EST on the due date.  The paper is to be posted in Assignment #2 drop box. Must cite to the source for all your facts in the text of your paper in APA format. Example of an in-text citation: (Ernst, & Young, 2000 p14). Example of source cited on Reference page: References Healthcare Financial Management Association (U.S.), Ernst, & Young. (2000). Health care system reform: A provider perspective : survey results. Westchester, Ill.: Healthcare Financial Management Association.  Except where noted, the assignment is written in clear, concise narrative. All sections of Assignment #2 are required.  Grading Rubric for written Assignment #2 is in Assignments area of the class.  
Due Date
Feb 7, 2023 11:59 PM

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CriteriaOutstandingSuperiorGoodBelow StandardFailureCriterion Score
Proper Titles for Laws & Financial Responsibilities 30%37.5 points Relevant federal and state statutes are all current and properly titled. Research represents a thorough canvass of the law and secondary sources. Demonstrated high degree of logic and reasoning when discussing the law and connecting to main points regarding three (3) financial responsibilities.  33.375 points Provided the proper title, statute and section number of applicable federal and state laws. Provided a comprehensive discussion of three (3) specific responsibilities under the financial management statute with proper citations to the law. 29.625 points Provided the proper title, statute and section number of only one (1) of the two  applicable laws. Provided a limited discussion of three (3) specific responsibilities under the financial management statute and or with limited citations to the law. 25.875 points Provided the title but not the proper statute and section number of applicable federal and/or state laws. Provided an inadequate discussion of three (3) or just one (1) specific responsibilities under the financial management statute and or with inadequate citations to the law. 12.375 points Student did not complete any of the assigned elements, missed key elements, made no meaningful attempt, and/or ideas are unrelated to the assignment.Score of Proper Titles for Laws & Financial Responsibilities 30%, / 37.5
Legal Consequences & Real Life Cases 25%31.25 points Student provided extensive original analysis of civil/criminal consequences, financial responsibilities and why agree/disagree with court’s decision. Goes substantially beyond points raised in classroom reading and discussions. Student has identified three (3) real life cases that are precedent, seminal, or not previously discussed in the Discussion Boards by the student, other students or the Professor.  27.8125 points Provided a comprehensive discussion of civil and criminal consequences from either the federal and or state law. Provided a comprehensive discussion of the specific consequences for violating the financial management statute. Provided three (3) specific real life case examples of health care organizations or health care providers found guilty of a legal or ethical breaches under the financial management statute. Provided sound reasoning why they agreed or disagreed with the results in the case. 24.6875 points Provided a limited discussion of civil and criminal consequences from either the federal and or state law and or provided a limited discussion of the specific consequences for violating the financial management statute. Provided only two (2) specific real life case examples of health care organizations or health care providers found guilty of a legal or ethical breaches under the financial management statute. Provided limited reasoning why they agreed or disagreed with the results in the case. 21.5625 points Provided an inadequate discussion of civil and criminal consequences from either the federal and or state law and or provided an inadequate discussion of the specific consequences for violating the financial management statute. Provided only one (1) or no specific real life case examples of health care organizations or health care providers found guilty of a legal or ethical breaches under the financial management statute. Provided inadequate reasoning why they agreed or disagreed with the results in the case. 10 points Student did not complete any of the assigned elements, missed key elements, made no meaningful attempt, and/or ideas are unrelated to the assignment.Score of Legal Consequences & Real Life Cases 25%, / 31.25
Remedial Management Actions & Conclusion 15%18.75 points 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. Thought provoking or interesting conclusion that ties everything together and furthers the thesis of the paper.  16.6875 points Comprehensive discussion of how three (3) specific remedial management actions or remedial steps, within their control as a manager, would ensure the financial management in the specific health care organization specifically met or exceeded federal or state law. Comprehensive summary of findings. 14.8125 points Limited discussion of how three (3) or just two (2) specific management actions or remedial steps, within their control as a manager, would ensure the financial management in the specific health care organization specifically met or exceeded federal or state law. Limited summary of findings.11.25 points Inadequate discussion of how three or less management actions or remedial steps, within their control as a manager, would ensure the financial management in the specific health care organization met or exceeded federal or state law. Fails to adequately summarize findings.2.4375 points Student did not complete any of the assigned elements, missed key elements, made no meaningful attempt, and/or ideas are unrelated to the assignment.Score of Remedial Management Actions & Conclusion 15%, / 18.75
Attention to Instructions 15%18.75 points Student demonstrated a full understanding of requirements; responded to each aspect of assignment; correctly developed required document format.16.6875 points Student demonstrated a general understanding of requirements; missed 1 minor aspect of assignment; document format is missing 1 element.14.8125 points Student demonstrated some understanding of requirements; missed a key element or 2 minor aspects of assignment; document format is missing 2 or more elements.11.25 points Student failed to show a firm understanding of requirements; missed 2 key elements or several minor aspects of assignment; document format is not complete or partially incorrect.0 points Student did not demonstrate  understanding of assignment requirements; the document format is not followed.Score of Attention to Instructions 15%, / 18.75
Clarity; grammar & APA 15%18.75 points Student’s writing is clear and easy to follow; grammar and spelling are all correct; formatting gives a professional look and adds to readability, no APA style errors16.6875 points Most ideas are presented clearly; occasional spelling and/or grammar issues (no more than 3), attempts in-text citation and reference list but 1 or 2 APA style errors are present14.8125 points Wordy; some points require rereading to understand fully; more than 3 occasional spelling and/or grammar errors, attempts in-text citation and reference list; APA style errors are present; inconsistencies in citation usage can be found throughout the document11.25 points Unclear and difficult to understand; frequent spelling and grammar issues (more than 6), attempts either in-text citation or reference list but omits the other0 points Very difficult to understand, poorly written in terms of mechanics and structureScore of Clarity; grammar & APA 15%, / 18.75

Total

Score of Assignment #2 Rubric Revised,

/ 125


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