The only part I need help with is the role of the physician: “What is your role in limiting self-referral or ancillary service abuse, and upcoding? Ex: proper documentation, etc.
The instructions for the whole assignment are as follows:
Work within your assigned groups to develop a policy to reduce the likelihood of facing liability for the False Claims, Anti-Kickback, and Stark laws (ALL THREE). To help you develop your policy, use a stakeholder approach. Using your perspectives I need to know what are the specific regulations for each section (False Claims, Anti-Kickback, and Stark Laws). Each of you will choose a role:
Compliance Officer/ Organization Administrator- How will this policy be monitored?
Physician – What is your role in limiting self-referral or ancillary service abuse, or upcoding?
Lawyer – What are the legal implications of violations and reporting for the organization? How will the organization handle reported violations?
Data collector – Provide the stats about violations and penalties associated with violations.
Develop a clear health organization policy to limit exposure for fraud and abuse. You are required to cite at least one source in APA.”
Again to be clear, I only need help with the role of the physician, none of the others. There should be about a paragraph or so for each of the three laws/statutes (Stark law, Anti-Kickbacks, and False Claims). I have also attached the Stark Law policy example that my professor included with her instructions. Please let me know if you have any questions. Thank you!
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