HCS/545 Organizational Responsibility and Current Health Care Issues

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Organizational Responsibility and Current Health Care IssuesName:HCS/545Date:Examine the case of Maxim Healthcare Services and its involvement in health care fraud.Discuss how the organization’s structure, governance, culture, and focus (or lack thereof) onsocial responsibility contributed to the fraudulent activities. Additionally, analyze the ethicalissues surrounding the situation and explore how government resources, such as the Health CareFraud Prevention and Enforcement Action Team (HEAT) and the Affordable Care Act, can helpprevent similar fraud in the future. Based on your analysis, recommend changes to MaximHealthcare Services' structure, governance, culture, and social responsibility initiatives that couldmitigate the risk of fraud and promote ethical business practices.Your response should demonstrate a thorough understanding of organizational responsibility,ethical frameworks, and how health care organizations can ensure compliance with legal andethical standards.Word count requirement: 1,500-2,000 words.

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Organizational Responsibility and Current Health Care IssuesHealth care fraud is a current health care issue throughout the health care industry. Healthcare fraud is considered abuse to the public treasury. “The National Health Care Anti-FraudAssociation (NHCAA) estimates that health care fraud accounts for at least three, but as much asten percent of total health care expenditures”(Hubbell, 2006). “Because health care fraud coststaxpayers more than $13.3 billion a year, seven federal and state agencies have made health carefraud prosecution a primary focus” (Hubbell, 2006). “The federal government concentrates ondetecting and prosecuting health care fraud in its health care insurance programs, Medicare andMedicaid” (Hubbell, 2006). Health care organizations that receive payment from the SocialSecurity Act are more likely to become targets of health care fraud with Medicare and Medicaid.There are many organizations that have been accused of health care fraud with Medicare and/orMedicaid.Maxim Healthcare Services is one of the health care organizations that have been accused ofhealth care fraud. The organizational structure and governance, culture and focus on socialresponsibility had an affect or influenced the situation of health care fraud and abuse. There areresources that can be allocated to prevent the situation in the future. Ethical issues wereconsidered and tied into the prevention decision. Changes in structure, governance, culture, orfocus on social responsibility could prevent this situation from happening in the future.Health Care News Situation

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