Option #1: Fraud Control
Examine Table 19-2 in your textbook and review the statutes, regulatory agencies, and organizations relevant to healthcare fraud (such as the Fraud Enforcement Recovery Act of 2009 [FERA] and the Patient Protection and Affordable Care Act [ACA]). Choose the initiative/organization that you believe has had the biggest impact on healthcare fraud control and write a paper discussing its impact. Consider the following questions:
- Does this statute/organization prevent or detect fraud?
- What type of fraud does it prevent/detect?
- How does it meet the challenges of fraud detection and prevention?
Your paper should be 3 to 5 pages in length (not including the title and reference pages), double-spaced, and in conformance with the CSU-Global Guide to Writing and APA Requirements, and it must include a minimum of three additional sources.
Option #2: Regulatory Requirements and Reporting
Research and determine which regulatory agencies/organizations govern financial reporting and solvency for different types of managed care organizations. Prepare a chart that compares/contrasts the approach of each agency. Your chart should include:
- A description of each agency
- The type of healthcare organization impacted
- Different aspects of its governance
Your chart should be prepared according to CSU-Global Guide to Writing and APA Requirements and include a minimum of three sources.