Theme 1 : Health care fraud is a form of white collar crime. It involves filing illegitimate health care claims to turn an illicit profit. The 3 major laws that protect against healthcare fraud are the Anti-kickback statute, Stark, and the False Claims Act. From the readings and independent research, find one (1) specific real life legal case example of how kickback arrangements would violate the Stark Law. In addition, discuss with your colleagues how the kickback arrangements could violate trust between provider organizations and patients. From the readings and independent research, find one (1) specific real life legal case example of a breach of the False Claims Act by a health-related organization. In addition, discuss whether health care organizations are properly equipped to ensure compliance and minimize exposure risks. If not why not?
Read the background articles. This discussion requires research beyond the articles. See Discussion Expectations and Grading for rules on discussions.
Assigned reading materials:
Theme 2 : Respond to the question below that has been assigned to you by this Thursday and then respond to TWO of your classmates responses (in an area different than your initial response) by Sunday. Please try not to replicate other’s responses and include the topic you are responding to at the beginning of your post.
Read:
1) Mayer Chapter 8:Imperfectly Competitive Markets
2) “The Increased Concentration… Can Lead to …”
http://www.healthaffairs.org/doi/pdf/10.1377/hltha…
3) Economic Theory Through Application– 8.5 Beyond Perfect Competition pg. 334-342
4) Economic Theory Through Application – 15.1 Market Power and Monopoly pg. 652-664
5) “How Might Proposed Mergers Impact State Insurance Markets”
6) Economic Theory Through Application – 15.3 Market with Small Number of Sellers pg. 675-693
Theme 3: Choose ONE (1) question below to discuss and then respond to TWO (2) of your classmates answers (Try not to repeat others answers). Include the question with your response.
Make sure you are properly citing your source(s) and providing your reference(s) for information you obtain from another source. Please review the Discussion Expectations and Grading posting if you have any questions regarding answering the discussion question and/or responding to your peers.