Governance and Fraud in Health Care Organizations - Legal and Ethical Responsibilities.docx

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RUNNING HEAD: Anti-Kickback StatuteGovernance and Fraud in Health Care Organizations - Legal and Ethical Responsibilities Ahmad ButlerUniversity of Maryland University College Legal and Ethical Issues in Health Care/HMGT 372 6380Professor: Vicky Powell
Anti-Kickback StatuteName of the LawThe Anti-Kickback Statute (AKS) was originally enacted in 1972 to protect patients and federal healthcare programs from fraud and abuse. The AKS is a criminal statute and federal law that appears in the United State Code, the official title is 42 U.S.C.§ 1320a-7b. The AKS is similar to the Stark law, but is broader and it prohibits anyone from offering, paying, soliciting, or receiving payment (monetary or otherwise) to induce or reward referrals or generate business for any program that participates in any federal program (Nisbett J., 2018).Management’s Financial ResponsibilitiesThere is not a business that doesn’t rely heavily on well-organized financial management principals, but within the healthcare industry it is undeniably important because of the already high cost of medical care in the country. Unless costs can be kept reasonable, patients and insurance companies are left to pay higher dollar amounts and with the Affordable Care Act (ACA), legislation is pulling the reins in tighter on what healthcare facilities can charge. There probably isn’t another industry in greater need of financial management than healthcare.There are numerous ethical responsibilities healthcare organizations need to uphold under the AKS. Two major responsibilities are to not except any illegal remunerations or hand out any illegal remunerations. Not excepting any remunerations is covered in section (b) paragraph (1) and reads; whoever knowingly and willfully solicits or receives any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind (Anti-Kickback Statute, 2010). Parts (A)
Anti-Kickback Statuteand (B) in paragraph (1) of this section explain what this means exactly in terms of receiving kickbacks. In the same section paragraph (2) explains the handing out of remunerations and reads; whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person (Anti-Kickback Statute, 2010). Parts (A) and (B) explain in more detail exactly what this means, just like the above paragraph. Another ethical responsibility organizations have is outlined in section (d) Illegal patient admittance and retention practices. Paragraph (1) states; charges, for any service provided to a patient under a State plan approved under subchapter XIX of

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