Course Objective for Assignment:

• Identify and apply ethical principles to the management and delivery of health care.
• Recommend structures and processes to manage compliance and to address ethical concerns in health care organizations.

From the list below, choose one topic related to financial management in health care organizations. Include a cover page and a list of references at the end of the paper in APA Format.  Paper will be double spaced and be 4-5 pages in 12 point New Times Roman font.

TOPICS

• False Claims Act
• Physician Self-Referral Act (Stark Law)
• Anti-kickback Statute
• • Civil Monetary Penalties Law
  • Exclusion Authorities
  • Tax Exemption (Non-profit Hospitals)
  • Anti-trust & Accountable Care Organizations
  • Deficit Reduction Act

  The assignment is to be written in clear, concise narrative. All sections in the outline for Assignment #2 are required.

  Outline:  Must use the headings from the outline below in your paper and the paper must be in narrative form not outline or bullet format. A penalty will be deducted from paper if underlined headings not used in your paper.

  1.    Name of the Law and or laws: 

  State the official title of the federal and/or state law, the statute and section number.  Must be either a federal statute or state statute and you must cite both if applicable. Thus if there is both a federal and state law that covers your subject picked then

  you must cite both. Do not assume that there is just a federal and or state law. In most cases there is both a federal and state law. You must use the laws cited in this section throughout the rest of the paper.

  2.  Management’s Financial Responsibilities: 

  What are the health care organization’s responsibilities under this financial management statute you stated above? Provide a comprehensive discussion of three (3) specific responsibilities under the financial management statute. State specifically after each responsibility  where this responsibility is stated in the federal or state law.  Describe the appropriate behavior and expectation. Include the citations and source of documents describing the organization’s responsibilities.

  3. Consequences for Ethical or Legal Breach:

Discuss in general the civil and criminal consequences from the law. Then identify from the news, three (3) specific case examples of health care organizations or health care providers found guilty of a legal or ethical breach relative to the law you have cited in first part of paper. Identify the specific legal and/or ethical breach and the penalties assessed to the health service organizations and/or individuals found guilty of violating the law or ethics [provide citation of law].  At the end of each case, discuss in detail whether you agree or not with the decision and why. Bring in the facts of the case to support your comments. Students should use a minimum of three (3) documented specific examples retrieved from the print media.

4. HCO Management’s remedial steps to reverse the non-compliance organizations:

Describe in detail three (3) specific management actions or remedial steps you would take to ensure the financial management in the health care organization meets or exceeds the federal law or state law relative to the requirements of the law you cited above. Discuss specifically how each of the three management actions specifically meets or exceeds the specific federal or state law you cited. Note: These actions may include specific uses of technology, procedures, human resource training, and other management tools.  However these action steps must be within the control of a manager.

5. Conclusion: Summary your findings above

6. Reference List [APA Format]…….

SOLUTION

Civil Monetary Penalties Law (CMPL)

Student

Maryland University Global

HMGT 372: Legal and Ethical Issues in Healthcare

11/12/2024

Civil Monetary Penalties Law (CMPL)

The Civil Monetary Penalties Law (CMPL), codified at 42 USC § 1320a-7a, is a federal statute within the Social Security Act that grants the Department of Health and Human Services (HHS), specifically the Office of Inspector General (OIG), the authority to impose fines on healthcare providers and organizations who violate federal healthcare program standards. The CMPL was designed to discourage fraudulent and abusive acts, particularly those involving Medicare and Medicaid, by penalizing actions that misuse federal funds. This law addresses financial mismanagement by imposing severe penalties for various offenses, including false claims, needless services, and unethical inducements to recipients. While the CMPL is federal, many states have equivalent restrictions or penalties for Medicaid fraud, allowing for state and federal enforcement. However, the federal CMPL remains the fundamental statute governing healthcare companies’ financial responsibilities under federally financed programs.

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