MHA/508 Navigating the Regulatory Environment in Health Care The Latest Version A+ Study Guide **********************************************
MHA 508 Entire Course Link https://www.onlinehelp123.com/mha-508 **********************************************
MHA 508 Wk 2 - Summative Assessment: Compliance Programs Matrix Your health care organization has had several small compliance incidents in the past two years, and the organization is now motivated to update its compliance program. Your executive leadership team asked you to review 2 health care compliance programs from similar organizations to determine how they constructed their compliance program and what aspects your organization should adopt. Select the type of health care organization you want represented in this assignment (e.g., family practice, hospital, urgent care, or nursing home). Locate 2 compliance program documents from comparable health care organizations using your Internet search engine. Read both compliance program documents and examine the similarities and differences between the 2. Create a matrix that compares how both organizations execute the following compliance components:
How internal monitoring and auditing is conducted How compliance and practice standards are implemented The designated compliance officer (or person designated to be the contact for compliance matters), who that person reports to, and their relationship to the organization’s governing board
How employees are trained and educated to model compliant behaviors How violations or offenses are detected, reported, and corrected How lines of communication with employees are developed How disciplinary standards are enforced Write a 525- to 700-word executive summary that informs your executive leadership about the matrix you created and offer your opinion as to which best practices the organization should adopt for its own compliance program. Cite your sources according to APA guidelines. Submit your report and article.
MHA 508 Wk 4 - Summative Assessment: Fraud and Abuse Enforcement Explore the OIG Enforcement Actions page. Review and select one of the articles on a case of health care fraud. Write a 700- to 1,050-word analysis of the case that includes the following:
Summarize the incident and the specific fraud that was enacted. Determine what laws were broken and which regulatory bodies are responsible for oversight of the regulations that were violated.
Describe the communications and information that would have been exchanged among the regulatory bodies and the offending organization during the investigation and charge of fraud or abuse in the case.
Explain the outcome of the case. If a judgment has not yet been passed, what do you think the outcome of the judgment should be? Justify your response. Format your citations according to APA guidelines. Submit your assignment.
MHA 508 Wk 5 - Group: HITECH Act and HIPAA Sanctions Assignment Individually, navigate to the Breach Portal on the Office for Civil Rights website and review the list of breaches of unsecured protected health information. As a team, discuss the following:
The states where the breaches occurred
The covered entity types The number of individuals affected in each breach The month and year when the breaches were reported The type of breach The location of breached information Look for trends and extract any information that can be useful for compliance within the organization. Individually, write a 150- to 300-word summary of your findings and discussion. Format your citations according to APA guidelines. Compile the responses into a single document. Submit your assignment.
MHA 508 Wk 6 - Summative Assessment: Root Cause Analysis Throughout this course, you have examined occurrences of the types of health care noncompliance, fraud, and abuse that commonly take place in the context of the regulatory environment in which organizations must operate. To ensure the best chance of avoiding intentional and unintentional noncompliance, health care administrators should devise and adopt a risk management plan that identifies, assesses, and analyzes the risks and tolerances inherent in the organizations processes and operations. One of the crucial aspects of a risk management plan involves strategies for actions that should be taken in the event of a violation or breach of any nature. These mitigating actions should be followed up with remediation aimed at finding the causes leading up to the incident. This is where root cause analysis comes into the picture. Root cause analysis is a structured, retrospective analysis of events leading up to the noncompliant event. By developing an organization-wide policy for conducting root cause analyses that is adaptable to specific operations, a cause might be determined, and preventive actions and solutions developed. In this assessment, you examine a case of fraud and try to determine why and how it happened. Read Maryland Health Care Provider Sentenced to 10 years in Federal Prison for Health Care Fraud Resulting in Patient Deaths from the United States Attorney's Office.
Use the Five Whys to conduct a root cause analysis to determine why the Medicare fraud occurred and Timothy Emeigh’s participation in the case. Write a 700- to 1,050-word analysis that identifies and evaluates the root cause for Medicare fraud in this case. Include the following:
Articulate the “Five Whys” for this case and provide an explanation for each. Speculate how and why Mr. Emeigh participated in the scheme. Explain what you, as an administrator, might have done to prevent this from happening. Recommend risk management strategies the organization can utilize to prevent this and similar types of events from occurring in the future. Cite your sources according to APA guidelines. Submit your report and article.