The provider seems to have imposed budgetary constraints

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Reference no: EM132308305

You lead a multi-disciplinary team that deals with compliance issues for GoodHealth, Inc., a large healthcare provider that owns four hospitals. Your team did some investigating, including internal audits and confidential interviews, and they found the following:

(1) the provider seems to have imposed budgetary constraints that they knew or should have known would prevent facilities from providing adequate care;

(2) care that is not of acceptable quality is being provided;

(3) there are medical coding errors going five years back that will likely total millions of dollars;

(4) medical errors are not being consistently reported; and,

(5) physician peer review for medical errors is not taking place in a consistent or timely manner.

Your team has concluded that it is in the best interest of GoodHealth, Inc. to self-report to the OIG. What are the penalties that OIG can impose based on the following issues identified at GoodHealth, Inc.? How should this be approached?

Reference no: EM132308305

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