- Consider the settlement in U.S. v. Halifax and the Corporate Integrity Agreement entered into by Halifax Hospital Medical Center, which addresses methods for preventing Anti-Kickback violations.
- What measures required by the Corporate Integrity Agreement do you believe will be most effective in preventing future violations?
- Which, if any, do you think will be least effective or ineffective in preventing future Anti-kickback violations? Explain your reasoning.
- What is a Medicaid Integrity Plan? Who is responsible for creating and maintaining it? What does it cover?
- The Physician Self-Referral law (Stark law) prohibits physician referral to designated health services (DHS) in which the physician or family member has an ownership interest. As a health care administrator what could you do to monitor this?
- The False Claims Act is often linked to billing problems such as upcoding, billing for non-medically necessary services, services not provided, unbundled services, etc. What billing strategies could you implement to lessen the likelihood for a False Claims Act problem?
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