Developing a Healthcare Finance Fraud, Abuse & Compliance Program Assignment

Compliance is a comprehensive program that helps institutions and their employees conduct operations and activities ethically; with the highest level of integrity, and in compliance with legal and regulatory requirements. To have an effective compliance program, an organization must establish and maintain an organizational culture that “encourages ethical conduct and a commitment to compliance with the law.” U.S. Federal Sentencing Guidelines §8B2.1(a)(2)

The local county has voted in approval to build a large state-of-the-art level IV hospital. With so many tasks ahead of the developers and the healthcare organization, you were recently hired as the new Chief Finance Officer (CFO). One of the first priorities you have been tasked to complete is the design and implementation of a comprehensive Healthcare Finance Fraud, Abuse & Compliance Program in order to establish a gateway between revenue and reimbursement practices and the ethical and professional adherence to applicable federal laws.

Deliverables: The final product to submit is a comprehensive Healthcare Finance Fraud, Abuse & Compliance Program that includes the following. Submit one (1) single Microsoft PowerPoint presentation for Part I. and one (1) single Microsoft Word for Part II.


· Using the following website, or feel free to utilize the Office of Inspector General (OIG) website at,d.eWE, select a real-time healthcare fraud news report in order to feature within your Power Point presentation to educate the organization on the various cases, the importance of healthcare finance compliance practices and the potential criminal and monetary fines that can be imposed on the individual and/or organization. Design a 7-10 slide Power Point presentation that provides a succinct overview of healthcare finance fraud, abuse and compliance the intent is for a future mandatory automated training; therefore audio is required).

· The name of the organization

· Discuss the events that occurred

· Identify if the events that occurred is a violation of one of the following related federal laws and explain why:

· The Anti-Kickback Statute

· The False Claims Act

· The Physician Self-Referral Law (Stark Law)

· Exclusion Statute

· Civil Monetary Penalties Law

· Identify the parties involved

· What penalties were enforced

· A summary of lessons learned that can serve as a teachable moment for your organization

· Presentation can include clip art, links to additional sources

· Must include recorded audio of each presentation’s slide

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