Analyzing Healthcare Finance Fraud Case Study

Analyzing Healthcare Finance Fraud Case Study

Table of Contents

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Instructions

Analyzing Healthcare Finance Fraud Case Study

Instructions

Compliance is a comprehensive program that helps institutions and their employees conduct operations and activities ethically; with the highest level of integrity, and in compliance with legal and regulatory requirements. To have an effective compliance program, an organization must establish and maintain an organizational culture that “encourages ethical conduct and a commitment to compliance with the law.” U.S. Federal Sentencing Guidelines §8B2.1(a)(2).

Using the OIG website (https://oig.hhs.gov/) or another of your choosing, select a real-time healthcare fraud news report from your local area to feature

Analyzing Healthcare Finance Fraud Case Study

Develop a 3–5-page white paper using the case as the point of application for the financial compliance process and that provides a succinct overview of the healthcare finance fraud committed applied to the chosen case.

The potential criminal and monetary fines that can be imposed on the individual and/or organization from the case.

Explain what financial compliance processes could have prevented the occurrence of this case.

What loopholes in the applicable law or the system the perpetrators used to commit the fraud?

Analyzing Healthcare Finance Fraud Case Study

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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