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HCS/545 Organizational Responsibility and Current Health Care Issues

This assignment covers organizational responsibility and key current issues in healthcare, analyzing the challenges faced by healthcare systems.

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    Organizational Responsibility and Current Health Care Issues Name: HCS/545 Date: 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) on social responsibility contributed to the fraudulent activities. Additionally, analyze the ethical issues surrounding the situation and explore how government resources, such as the Health Care Fraud Prevention and Enforcement Action Team (HEAT) and the Affordable Care Act, can help prevent similar fraud in the future. Based on your analysis, recommend changes to Maxim Healthcare Services' structure, governance, culture, and social responsibility initiatives that could mitigate 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 and ethical standards. Word count requirement: 1,500 - 2,000 words.

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    Organizational Responsibility and Current Health Care Issues Health care fraud is a current health care issue throughout the health care industry. Health care fraud is considered abuse to the public treasury. “The National Health Care Anti - Fraud Association (NHCAA) estimates that health care fraud accounts for at least three, but as much as ten percent of total health care expenditures”(Hubbell, 2006). “Because health care fraud costs taxpayers more than $13.3 billion a year, seven federal and state agencies have made health care fraud prosecution a primary focus” (Hubbell, 2006). “The federal government concentrates on detecting and prosecuting health care fraud in its health care insurance programs, Medicare and Medicaid” (Hubbell, 2006). Health care organizations that receive payment from the Social Security 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/or Medicaid. Maxim Healthcare Services is one of the health care organizations that have been accused of health care fraud. The organizational structure and governance, culture and focus on social responsibility had an affect or influenced the situation of health care fraud and abuse. There are resources that can be allocated to prevent the situation in the future. Ethical issues were considered and tied into the prevention decision. Changes in structure, governance, culture, or focus on social responsibility could prevent this situation from happening in the future. Health Care News Situation

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