Healthcare

Describe instances of your applied critical thinking to develop solutions to problems and how that skill will aid your future patient care, leadership and advocacy. Give examples of your application of critical thinking skills to problem-solving. Discuss in detail your ability to apply this skill as a PA student and in the practice as a PA.

Topic : Billing, antitrust exemption changes upend negotiations between insurers and providers

APA format: Paper must be three pages in length (not including title page), double-spaced, 12 point Times New Roman or Arial font; 1” margins. Title page 3 page report Reference page Resources: A minimum of three approved sources must be used to support your information. Wikipedia is not a valid site and should not be used. These sources must be used within the text of the report and included in the Reference page at the end of the report. Do not plagiarize.

Instructions: Visit the U.S. Dept. of Health and Human Services (HHS) website. The link below will provide actual cases of Healthcare Fraud violations: (Links to an external site.) Choose one case and please use the following questions as prompts to discuss in your initial response. Provide the title of your Healthcare Fraud violation, a summary of the violation, and the outcome to include any fines and actions taken by the OIG. Summarize your professional opinion of the violation (please do not state agree or disagree). Have you experienced any Healthcare Fraud violations personally or in your employment? If so, provide a summary of the violation and outcome. Please be sure to validate your opinions and ideas with citations and references in APA format The article is below Two Defendants Plead Guilty to Multi-Million Dollar Medicare Fraud Scheme BOSTON – A Colorado woman and a Florida woman pleaded guilty today in connection with a multi-million dollar Medicare fraud scheme. Jessica Jones, 30, of Louisville Colo., and Elizabeth Putulin, 30, of Coconut Creek, Fla., each pleaded guilty to one count of conspiracy to commit health care fraud. U.S. District Court Senior Judge George A. O’Toole, Jr. scheduled sentencing for May 19, 2021. Jones and Putulin conspired with Juan Camilo Perez Buitrago to submit more than $109 million in false and fraudulent claims for durable medical equipment (DME) such as arm, back, knee and shoulder braces. In October 2020, Perez pleaded guilty to health care fraud and paying kickbacks in connection with a federal health care program and is scheduled to be sentenced on March 4, 2021. Jones and Putulin helped Perez manufacture and submit false and fraudulent Medicare claims by establishing shell companies in more than a dozen different states, including Massachusetts. Perez directed employees, including Jones and Putulin, to list his mother, wife and yacht captain as corporate directors and to use fictitious names when registering the shell companies as DME providers. At Perez’s request, Jones and Putulin purchased Medicare patient data from foreign and domestic call centers that targeted elderly patients, and instructed call centers to contact the Medicare beneficiaries with an offer of ankle, arm, back, knee and/or shoulder braces “at little to no cost.”  Perez then submitted Medicare claims for those patients without obtaining a prescriber’s order to ensure that the braces were medically necessary. It is further alleged that he submitted blatantly fraudulent claims, including claims for deceased patients and repeat claims for the same patient and the same DME. Perez failed to provide any DME for more than $7.5 million in claims. When Perez did provide DME to patients, he typically billed insurance policies more than 12 times the average price of the DME that he provided to the patient. Jones and Putulin further facilitated the fraud by answering frequent phone calls from Medicare patients who received DME that they did not request, want or need. Jones and Putulin also responded to insurance companies’ requests for prescriber’s orders and medical records, which they were unable to provide. The charging statute provides for a sentence of up to 10 years in prison, three years of supervised release and a fine of $250,000. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors. United States Attorney Andrew E. Lelling; Johnnie Sharp Jr., Special Agent in Charge of the Federal Bureau of Investigation, Birmingham Field Division; Phillip Coyne, Special Agent in Charge of the Department of Health and Human Services, Office of the Inspector General, Boston Division; and Joseph W. Cronin, Inspector in Charge of the U.S. Postal Inspection Service made the announcement today. Assistant U.S. Attorney Elysa Q. Wan of Lelling’s Health Care Fraud Unit is prosecuting the case. Topic(s): Health Care Fraud Component(s): USAO – Massachusetts

A gap in efficiency related to the rising cost of pharmaceuticals for the aging population. • Describe a specific gap in the delivery of healthcare. Include the specific population affected by the gap. • Briefly describe the history of this gap in access to healthcare. Has this been an issue historically, or is it a modern issue? • Explain the impact that the socioeconomic background of the population has on their access to healthcare. • Describe how the healthcare delivered to the population is affected by the gap in access. • Predict any potential implications if this gap in access is not addressed.

Review the attached document and investigate and evaluate the financial implications of the selected healthcare policy. Explain why the policy exists and if the main focus is access, cost, or quality. What services are provided? What is the cost of those services? Who and how are the services paid for? Some of you might find specific answers to some of these questions; others will have to make assumptions, backed by research, to answer these questions.

Please briefly respond to each of the following …I.    Describe the COVID-19 pandemic from a public health perspective.o    Characteristics of the virus and how it spreads.o    Morbidity and mortality rate.II.    Explain why it is a public health problem.III.    Describe the intersection of the social determinants of health and COVID-19.o    How has COVID-19 been impacted by the SODH?o    Identify one social determinant of health and expand how it has impacted mortality or morbidity of COVID-19. Provide evidence.IV.    Describe the impact of COVID-19 on vulnerable populations.o    Define vulnerable populationo    Discuss how COVID-19 has impacted vulnerable populationso    Select one vulnerable population and describe the impact of COVID-19 on the vulnerable population you selected.

Choose a subject in health care that is of interest to you. Examples might include health behaviors, epidemiology, health information, wellness activities, etc. Research a possible issue or problem within this area of health care. Form a hypothesis for how to solve the issue or problem you have identified and use the scientific method to create and test your hypothesis. Create charts, graphs or maps to illustrate the data from your research. Using critical thinking and problem solving skills, how can health science professionals be successful in improving this problem?

submit an evidence-based practice paper about cultural competency in mental health nursing. An evidence-based practice paper allows you to explore best practice and help improve client outcomes on a psychiatric unit. Your paper should describe how you, as a nurse, will include – or have included – cultural awareness in a client diagnosed with a mental illness. The person you describe could be someone in your clinical setting, someone you have worked with in the past, or a theoretical client. Remember that culture can also include gender equality, sexual orientation, and other cultures besides race and religion – including cultures unique to one particular family. Assessment: Discuss what you would assess in regard to a client’s culture. For example, are there specific dietary requirements? Are schedule changes necessary to avoid conflicts with religious practices? Who is the spokesperson for the family? What would you assess? Diagnosis: List any mental health nursing diagnoses this person has or may be at risk for. Include at least one cultural diagnosis. Planning: What planning needs to be done to ensure the cultural and emotional safety of the client? Implementation: What are interventions that would ensure the safety of your client in regard to culture? Include at least two interventions. For example, if your client has religious beliefs that affect the ability to take medications, what interventions would you create to ensure the client’s safety? What can you do to make sure the client’s cultural needs are met? Evaluation: How will you evaluate whether your implementation was effective? Make sure the parameters are objective and measurable. In your summary, discuss whether any completed interventions were successful. What could be done differently in the future? If the interventions have not yet been carried out, you might discuss some institutional changes that could be made to ensure cultural safety for all clients in that setting. Your paper should utilize proper APA guidelines and include at least three scholarly sources to support your paper. A scholarly source is a source that has been peer reviewed and has appropriate authors that are credentialed. For more information on APA please use a few in text citations and references that can be checked.

Your Office Manager has asked you to participate in writing a letter for patients who would like information on the Medicare options.The letter should explain the parts of Medicare, their differences, and features.For this assignment, write a 2-3-page letter discussing Medicare Parts A, B, C, and D.Review Unit 2, Topic 2 Content and website links provided to assist you in writing the letter.Requirements:2-3-page letter format, using proper APA formatUse a professional tone when addressing patients.Clearly define and describe the four parts of Medicare so the patient will understand them.Please be sure to validate your opinions and ideas with citations and references in APA format.Please be cautioned that any material used in the assignment directly from the internet (copy and paste) will be given a zero-based on Herzing University Ethics Policy (Plagiarism). All information not your own must be given appropriate APA citation reference.