Stand Alone Project Compliance Sample

This Stand-Alone Project requires you to define the purpose and scope of compliance in a physician’s practice, and to outline and explain the laws and requirements meant to enforce compliance within the practice. As a newly hired compliance manager in a group practice with seven physicians, you’re tasked with reviewing various compliance regulations and providing feedback to the physicians regarding the level of compliance within the facility. 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 False Claims Act Violations: Define and discuss at least five different high risk areas for FCA violations and healthcare providers and present them to your employer, the physician group, in the form of a two-page essay.
Part B Stark Law Violations: Identify the potential repercussions of a Stark Law violation for a physician’s office, and explain how an office can manage those situations to reduce the risk of legal exposure—again in the form of an essay to your employer. Cite at least two examples of Stark Law violations in physician practices that you find online.
Part C Practice Merger: Your employer, the physician practice, is considering merging with another local physician group. Define and discuss the antitrust laws that would apply to this merger, paying specific attention to the Clayton Act, the Sherman Antitrust Act, and the FTC Act. Also include the penalties that may be assessed for violation of these laws.
Part D Notice of Privacy Practices: Your employer, the physician practice, wants you to review and update its Notice of Privacy Practices (NPP). Discuss the requirements and responsibilities of the NPP and a patient’s rights to PHI, as well as the information that should be included in the notice.
Part E Medical Equipment Supplier: A physician within the practice you manage wants to rent a space in the back of the office to the medical equipment supplier the office uses regularly. Discuss how this action may be a violation under a Special Fraud Alert issued by the Office of the Inspector General. Conversely, describe how this action may be allowed under Safe Harbors.
Part F Internal Audit: You’re performing an internal audit on bill claims and notice that the previous office manager was keeping overpayments from payers and patients unless they specifically requested it, which is a violation. In an essay to your employer, the physician group practice, provide and discuss three self-disclosure advantages of the office reporting the violations before they’re discovered. Then, provide and discuss three self-disclosure disadvantages of the office reporting the violations before they’re discovered.