Compliance Laws and Regulations on Different Healthcare Organizations

This Stand-Alone Project requires you to research compliance laws and regulations within different healthcare organizations. You’ll also provide real-world examples of evidence of compliance programs within these different organizations. The project should reference sources like the Internet, media, and/or government websites. You may also reference textbooks, industry publications, journals, news media, etc. to further support your discussion. A table of contents and a bibliography listing only those works that you cited in your analysis are required. Your Stand-Alone Project responses should be both grammatically and mechanically correct and formatted in the same fashion as the project itself. If there is a Part A, your response should identify a Part A, etc. In addition, you must appropriately cite all resources used in your response and document them in a bibliography using APA style. (A minimum 10-page, double-spaced response is required for the combination of Parts A through F.) (200 points)
Part A Physician Offices: Discuss seven different steps to creating a voluntary compliance program for a physician’s office. Then, locate and discuss at least two examples of evidence of compliance programs within physicians’ offices by performing an Internet search. Use the Required Readings, your textbook, and articles and websites you find by doing your own research. Include a bibliography formatted in APA style.
Part B Nursing Homes: Discuss how the Patient Protection and Affordable Care Act relates to nursing homes and provide at least three benefits of a nursing home compliance program. Then, locate and discuss at least two examples of evidence of compliance programs within nursing homes by performing an Internet search. Use the Required Readings, your textbook, and articles and websites you find by doing your own research.
Part C Hospice: Identify and discuss five major risk areas that are specific to hospice compliance. Then, locate and discuss at least two examples of evidence of compliance programs within hospices by performing an Internet search. Use the Required Readings, your textbook, and articles and websites you find by doing your own research.
Part D Ambulance Services: Identify and discuss the four conditions that must first be met before an ambulance service can waive or reduce cost-sharing amounts without violating the Anti-Kickback Statute. Then, locate and discuss at least two examples of evidence of compliance programs for ambulance services by performing an Internet search. Use the Required Readings, your textbook, and articles and websites you find by doing your own research.
Part E Third-Party Billers: Discuss the relationship between providers and third-party billing companies and the responsibility between the two for fraudulent claims filing. Be sure to explain the penalties under FCA for knowingly submitting false claims to Medicare. Then, locate and discuss at least two examples of evidence of compliance programs for third-party billing companies by performing an Internet search. Use the Required Readings, your textbook, and articles and websites you find by doing your own research.
Part F DMEPOS Providers: Explain overutilization and the ways in which DMEPOS providers can help prevent this risk from happening. Be sure to include the three conditions required by payers for approval and what to do if overutilization seems to be happening regularly from the same provider. Then, locate and discuss at least two examples of evidence of compliance programs for DMEPOS providers by performing an Internet search. Use the Required Readings, your textbook, and articles and websites you find by doing your own research.