Follow rubric verbatim
What to Submit
Submit your memo as a 3- to 4-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Also include a title page. Sources should be cited according to APA style.
rubric1.pdf
4/17/24, 9:42 AM Assignment Information
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IHP 630 Module Eight Activity Fraud, Waste, and Abuse Reduction Memo Guidelines and Rubric
Overview
In this module, you explored the importance of documentation in government compliance and reporting. When assisted by technology, documentation becomes easier to capture and maintain,
as well as less prone to errors, which in turn improves the patient experience.
This activity will help you describe how technology supports regulatory compliance in healthcare. It also enables you to explain how regulation, fraud, and abuse impact operations and patient
care.
Scenario
You work within a healthcare organization as the director of quality, and your chief compliance of�cer has asked you to create a memo to be distributed to the entire organization. They have
asked that the memo focus on how an organization can better manage risk to the revenue cycle and healthcare reimbursement by examining ways to reduce fraud, waste, and abuse.
Directions
Create a memo to assess how the following laws and regulations can help a healthcare organization reduce fraud, waste, and abuse and thereby manage risk to the revenue cycle and
reimbursement. Also, recommend strategies and technology to help an organization abide by the laws and regulations. Refer to the following laws and regulations to guide your response:
False Claims Act
Physician Self-Referral Law
Anti-Kickback Statute
Anti-Trust Laws
You may refer to the “Activity Reading” resource in the module resources section to better understand how a memo is structured. If you need writing support, access the Online Writing Center
through the Academic Support module of your course.
Speci�cally, you must address the following rubric criteria:
1. False Claims Act: Analyze the impact of the False Claims Act on the organization’s reimbursement, coding, and strategic planning. Consider the following questions to guide your
response:
What are the provisions of the False Claims Act?
What penalties could an organization face for violating the Act?
2. Physician Self-Referral Law: Analyze the impact of the Physician Self-Referral Law on a healthcare organization’s reimbursement, revenue cycle, and strategic planning. Consider the
following questions to guide your response:
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What are the features of the Physician Self-Referral Law?
How does this law help prevent fraud and abuse in healthcare?
3. Anti-Kickback Statute: Analyze the impact of the Anti-Kickback Statute on healthcare reimbursement and referrals. Consider the following questions to guide your response:
How is the Anti-Kickback Statute different from the Physician Self-Referral Law?
What kind of �nancial penalties would be attracted by the violation of this statute?
4. Anti-Trust Laws: Analyze the impact of the Anti-Trust Laws on a healthcare organization’s �nancial performance and strategic planning. Consider the following questions to guide your
response:
What are the premises of the Anti-Trust Laws?
How do the Anti-Trust Laws help prevent fraud and abuse in healthcare?
5. Recommendations: Recommend strategies and technology to reduce operational risk and promote operational ef�ciencies by integrating the regulations that prevent fraud, waste, and
abuse. Consider the following questions to guide your response:
What measures can you take to incorporate the provisions of the False Claims Act and the Anti-Trust Laws?
What process changes will help the organization comply more easily with the Physician Self-Referral Law and the Anti-Kickback Statute?
All the claims in your deliverable should be evidence based. Your citations should be from your independent search for evidence (not from the textbook or module resources) of credible
sources and be current within the last �ve years. You are required to cite a minimum of two sources, at least one of which should be separate from your own research. Refer to the IHP 630
Library Guide located in the Start Here section of the course for additional support.
What to Submit
Submit your memo as a 3- to 4-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Also include a title page. Sources should be cited
according to APA style.
Module Eight Activity Fraud, Waste, and Abuse Reduction Memo Rubric
Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value
False Claims Act Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Analyzes the impact of the
False Claims Act on a
healthcare organization’s
reimbursement, coding, and
strategic planning
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value
Physician Self-Referral Law Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Analyzes the impact of the
Physician Self-Referral Law on
a healthcare organization’s
reimbursement, revenue cycle,
and strategic planning
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Anti-Kickback Statute Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Analyzes the impact of the
Anti-Kickback Statute on
healthcare reimbursement and
referrals
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Anti-Trust Laws Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Analyzes the impact of the
Anti-Trust Laws on a healthcare
organization’s �nancial
performance and strategic
planning
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Recommendations Exceeds pro�ciency in an
exceptionally clear and
insightful manner, using
industry-speci�c language
Recommends strategies and
technology to reduce
operational risk and promote
operational ef�ciencies by
integrating the regulations that
prevent fraud, waste, and abuse
Shows progress toward
pro�ciency, but with errors or
omissions
Does not attempt criterion 15
Articulation of Response Exceeds pro�ciency in an
exceptionally clear and
insightful manner
Clearly conveys meaning with
correct grammar, sentence
structure, and spelling,
demonstrating an
understanding of audience and
purpose
Shows progress toward
pro�ciency, but with errors in
grammar, sentence structure,
and spelling, negatively
impacting readability
Submission has critical errors in
grammar, sentence structure,
and spelling, preventing
understanding of ideas
10
Scholarly and Professional
Sources
Incorporates more than two
scholarly, current (within the
last �ve years) sources, or use
of sources is exceptionally
insightful
Incorporates two scholarly,
current (within the last �ve
years) sources that support
claims
Incorporates fewer than two
scholarly, current (within the
last �ve years) sources, or not
all sources support claims
Does not incorporate sources 10
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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value
APA Style Formats in-text citations and
reference list according to APA
style with no errors
Formats in-text citations and
reference list according to APA
style with fewer than �ve
errors
Formats in-text citations and
reference list according to APA
style with �ve or more errors
Does not format in-text
citations and reference list
according to APA style
5
Total: 100%
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