Dealing With Fraud In The Healthcare Industry
Dealing with Fraud
Joseph B. Amah
Professor Dr. Wanda E. Allen
HSA 515 Law and Health Care System
Strayer University
Delaware County Campus
June 18, 2013
Abstract
Fraudulent behaviors have deep rooted history in most American organizations, including medical institutions. There is no doubt, therefore, that one of several ways an administrator can succeed as a Chief Nursing Officer (in a facility wrecked by news of abject corruption and empirical fraudulent activities) is being knowledgeable about these historical facts and taking corrective actions. Necessarily, any report of dishonest behaviors such as the one relating to the subject of this paper, will be addressed by a …show more content…
A litany of governmental and other statutory regulations such as the Sarbanes-Oxley Act and an extended list of state regulations all speak to this high public expectation. While boards of directors may be charged with the responsibility of addressing these issues, “directors of healthcare organizations also have important responsibilities that need to be met relating to corporate compliance requirements unique to the healthcare industry. Incidentally, it turns out that in order for a medical facility to meet such high public demand/expectation, a corporate integrity program and/or guidelines must be drawn up and put in place. Subsequently, for the new facility to successfully forge ahead with firmer policies, corporate integrity guidelines must be devised and timely applied at all levels of the institution. The rudiments of these guidelines shall comprise 1) adherence to the application of duty of care, 2) adherence to federal and local regulatory provisions and 3) the exercise of moral principles and ethics in the work place, among others. Let us briefly discuss each of these …show more content…
Showalter (2012) refers to duty of care as prudence that a reasonable person would carry out under the same or similar circumstances. Secondly, exercise of moral principles and ethics by employees effectively avoids deceitful action and mitigate fraudulent behaviors. For example, the fact that people should not lie is “based on the moral principle of respect for people’s autonomy. Principles are useful in discussions because people who do not agree … on certain actions may be able to agree in principle”(Blais, Hayes, Kozier, & Erb, 2006, p.54). Application of appropriate ethics in the work place will help boost organizational integrity and enhance productivity. Because it applies to the method of inquiry that help people understand the morality of other people (Blais et al. 2006), good ethical practice in the work place helps employees understand the behavior of various groups such as physicians or nurses. In all this, however, healthcare managers must be careful in the way they monitor compliance programs in the
Joseph B. Amah
Professor Dr. Wanda E. Allen
HSA 515 Law and Health Care System
Strayer University
Delaware County Campus
June 18, 2013
Abstract
Fraudulent behaviors have deep rooted history in most American organizations, including medical institutions. There is no doubt, therefore, that one of several ways an administrator can succeed as a Chief Nursing Officer (in a facility wrecked by news of abject corruption and empirical fraudulent activities) is being knowledgeable about these historical facts and taking corrective actions. Necessarily, any report of dishonest behaviors such as the one relating to the subject of this paper, will be addressed by a …show more content…
A litany of governmental and other statutory regulations such as the Sarbanes-Oxley Act and an extended list of state regulations all speak to this high public expectation. While boards of directors may be charged with the responsibility of addressing these issues, “directors of healthcare organizations also have important responsibilities that need to be met relating to corporate compliance requirements unique to the healthcare industry. Incidentally, it turns out that in order for a medical facility to meet such high public demand/expectation, a corporate integrity program and/or guidelines must be drawn up and put in place. Subsequently, for the new facility to successfully forge ahead with firmer policies, corporate integrity guidelines must be devised and timely applied at all levels of the institution. The rudiments of these guidelines shall comprise 1) adherence to the application of duty of care, 2) adherence to federal and local regulatory provisions and 3) the exercise of moral principles and ethics in the work place, among others. Let us briefly discuss each of these …show more content…
Showalter (2012) refers to duty of care as prudence that a reasonable person would carry out under the same or similar circumstances. Secondly, exercise of moral principles and ethics by employees effectively avoids deceitful action and mitigate fraudulent behaviors. For example, the fact that people should not lie is “based on the moral principle of respect for people’s autonomy. Principles are useful in discussions because people who do not agree … on certain actions may be able to agree in principle”(Blais, Hayes, Kozier, & Erb, 2006, p.54). Application of appropriate ethics in the work place will help boost organizational integrity and enhance productivity. Because it applies to the method of inquiry that help people understand the morality of other people (Blais et al. 2006), good ethical practice in the work place helps employees understand the behavior of various groups such as physicians or nurses. In all this, however, healthcare managers must be careful in the way they monitor compliance programs in the