Week 1

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Complete an APA formatted 2 page paper (not including the title and reference pages) answering the following questions:

1. What are five elements pertaining to the establishment of a false claim under the False Claims Act?

2. HIPAA privacy standards were designed to accomplish what three broad objectives? Explain each.

3. Stark II laws prohibit physician referrals to entities in which the physician has a financial relationship. What are 10 specific designated health services (DHS) for which referrals by physicians who have financial relationships with the entity providing the DHS are prohibited?

4. Discuss the following:

a. Qui tam

b. HIPAA Privacy Rule

c. EMTALA

d. Compliance programs

SHORT ESSAY QUESTIONS:

1) Are there any other types of information besides financial that may be useful in making financial decisions?

2) Identify the major components of a corporate compliance plan, including the establishment of internal controls relating to the finances of an organization.

3) How does legal and regulatory issues shape and define good financial management of a health care organization?

4) Discuss the major reimbursement methods used in health care.

5) Discuss the major aspects of Medicare benefits.

6) List some of the important considerations when negotiating a health plan contract.

Total quality management:

Short essay questions:

1) What is total quality management (TQM)? Is it something you can install, like a refrigerator? How do you know TQM when you see it?

2) When we talk about a system view, what are we interested in and why? Why is a system view so important to have if you are going to implement TQM?