Use only classroom materials to complete the discussion. This would include the

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Use only classroom materials to complete the discussion. This would include the textbooks, web links, and the Classroom law library.
Your two response replies should be to each of the other topics you were not assigned. Your reply posts should evaluate legal risks and consequences and discuss how to use tools to mitigate risk. Look for tool applications beyond those already discussed.
All groups read The Tracks We Leave Ch. 10 Failed Hospital Merger: Richland River Valley Healthcare System
Group 1/Contracting for Compliance
In the Law of Health Care Administration, 9th Ed. read:
Ch. 5 Contracts, pp. 175-189
Ch 13 Competition and Antitrust Law
Part 1: Critical Analysis of the Law
Evaluate the legal risks and consequences that can arise for failing to comply with laws that impact contracts. Evaluate the following laws:
Certificate of Need
Antitrust
Corporate Practice of Medicine (CPOM)
Evaluate 3 contract clauses from the list below. For each clause selected indicate the type of risk it will mitigate and how you would use each of the 3 clauses as a risk mitigation tool.
Alternative dispute resolution (ADR) clauses
Limitation of Liability clause
Periodic Reporting and Right to Audit
Termination clauses
Legal Compliance clause
Data Protection Clause
Insurance requirement to cover liability
How would a comprehensive cloud based contract management system limit contract risk? How would a comprehensive contract management system prevent the problems in The Tracks we Leave, Chapter 10 Failed Hospital Merger: Richland River Valley Healthcare System?
Part 2: Strategic Compliance with the Law
You are an administrator in a very busy clinic in the same managed care organization (MCO) as the local hospital. Five of your providers (Dollar Docs) regularly refer to a nearby home health agency the five own. The home health agency is the sole provider of home health services in a five-county area. The home health agency wants to expand and open more home health agencies in other counties and be the sole provider in those counties as well. The home health agency is located in Maryland which requires a certificate of need for home health. The home health agency would like to employ a physician.
What laws (from those your group was assigned to evaluate) does this arrangement violate? Why? What are the consequences of the violation(s)?
Compare and contrast how the 3 compliance actions from the 1.2 lists or 1.3 actions. How would they apply to this situation? Which do you prefer to use to correct the issue? Why?
Create a corrective action plan with five actions you could take to correct the problem including the specific compliance strategy selected.
Group 2/Corporate Documents for compliance
In the Law of Health Care Administration, 9th Ed. read:
Ch. 12 Taxation of Healthcare Institutions
Part 1: Critical Analysis of the Law
Evaluate the legal risks and consequences that can arise for failing to comply with the laws that govern corporate practices. Evaluate the following laws.
State Incorporation Laws
Non-Profit Tax Law
Sarbanes Oxley Law (SOX)
Evaluate 3 corporate documents from the list below. For each corporate document selected indicate the type of risk it will mitigate and how you would use each of the 3 documents as a risk mitigation tool.
Corporate Organization Document – Articles of Incorporation
Corporate mission, vision, and values statements
Corporate Code of Ethics
Corporate Policies and Procedures
Corporate Contracts
Government reporting forms
Corporate annual report
How would an Enterprise Document Management (EDM) system limit corporate compliance risk? How would an Enterprise Document System (EDM) prevent the problems in The Tracks we Leave, Chapter 10 Failed Hospital Merger: Richland River Valley Healthcare System
Part 2: Strategic Compliance with the Law
You are an administrator in a very busy clinic in the same managed care organization (MCO) as the local hospital. Five of your providers (Dollar Docs) have office space in the hospital and they regularly refer to a nearby home health agency the five own. The Dollar Docs give you data from their practice in order for you to prepare an SEC report each year. You find out they have been “inflating” numbers to show even more profit than they have actually earned. They also refuse to provide charity care for those who come into for services they provide.
What laws (from those your group was assigned to evaluate) does this arrangement violate? Why? What are the consequences of the violation(s)?
Compare and contrast how the 3 compliance actions from the 1.2 lists or 1.3 actions. How would they apply to this situation? Which do you prefer to use to correct the issue? Why?
Create a corrective action plan with five actions you could take to correct the problem including the specific compliance strategy selected.
Group 3/HHS OIG Compliance Protocol
In the Law of Health Care Administration, 9th Ed. read:
Ch. 15 Fraud Laws and Corporate Compliance
Part 1: Critical Analysis of the Law
Evaluate the legal risks and consequences that can arise for failing to comply with the laws that govern fraud and abuse. Evaluate the following laws.
False Claims Act (FCA)
Antikickback Statute (AKS)
Physician Self-Referral Law (Stark law)
Evaluate 3 elements of the HHS OIG compliance protocol elements from the list below. For each element of the HHS OIG compliance, the protocol indicates the type of risk it will mitigate and how you would use each of the 3 elements as a risk mitigation tool.
Implementing written policies, procedures, and standards of conduct
Designating a compliance officer and compliance committee
Conducting effective training and education
Developing effective lines of communication
Conducting internal monitoring and auditing
Enforcing standards through well-publicized disciplinary guidelines
Responding promptly to offenses and taking corrective action
How would a comprehensive compliance program that adopts the entire HHS OIG protocol limit fraud and abuse risk? How would a comprehensive compliance program prevent the problems in The Tracks we Leave, 10 Failed Hospital Merger: Richland River Valley Healthcare System?
Part 2: Strategic Compliance with the Law
You are an administrator in a very busy clinic in the same managed care organization (MCO) as the local hospital. Five of your providers (Dollar Docs) have office space in the hospital where they enjoy free rent from the hospital. This makes it easy for the providers to send their patients to the hospital for additional needed services. The Dollar Docs also regularly refer to a nearby home health agency the five own.
What laws (from those your group was assigned to evaluate) does this arrangement violate? Why? What are the consequences of the violation(s)?
Compare and contrast how the 3 compliance actions from the 1.2 lists or 1.3 actions. How would they apply to this situation? Which do you prefer to use to correct the issue? Why?
Create a corrective action plan with five actions you could take to correct the problem including the specific compliance strategy selected.
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