Question

Pick any criminal case of conduct on the part of hospital or fraudulent conduct.

1. Discuss what happened in the case including the parties

2. facts of the case

3. violations

4. outcome

5. Discuss how you would have made a better/different choice

6. how if you were the manager, you might have handled the situation.

Answer 1

1.One of the major health care fraudulent activity was done by two nurses on Medicare. (Nwankowa and Ajaja ) There was a fraudulent activity of getting monetary profit of about $2.1 million .

2.The facts of the case are they billing was done for home health care services to the patient which was not offered to them ,also they charged for unnecessary procedures and services

3.This is violations of truth, professionalism ,or simply a forgery

4.The out come was they have to pay a hefty fine with 10years of imprisonment

5.A better or different choice could have been done by making strict rules and regulations. Periodic screening of the hospital for the reimbursement done. Screening of each individuals or professional who are involved in the Medicare reimbursement program .Ensuring proper coordination of the data .

6.Being a manager the situation can be handled by dismissing the fraud who has brought a major defame to the name of healthcare organization .Then making adequate training to the staffs to work honestly .Also ensuring the information department oversees any fraudulent activity of the employees.