Posted: January 20th, 2023
Dr. Pearson has recently been hired into the Central City Internal Medicine Group as its fifth physician. He has recently completed his residency and is eager to enter private practice. Dr. Pearson is introduced to Meredith and Dawn, two members of the billing staff for the practice. Unbeknownst to Dr. Pearson, Meredith financially assists the practice in several ways. She bills procedures by using individual codes instead of comprehensive codes, she has decided to bill Dr. Pearson’s services under the Medicare number of Dr. Craig (another Central City physician) until Dr. Pearson’s credentialing process has been completed, and habitually submits a claim more than once if she isn’t sure whether or not it has already been submitted.
Name the types of fraudulent billing that Meredith is conducting. (Name the specific Act)
Could Meredith be held liable for these activities?
Is Dr. Pearson subject to liability although he doesn’t know Meredith is conducting these activities? (Is Dr. Pearson responsible for the behavior of his staff?)
Once Meredith’s activities are discovered, how should her conduct be addressed by her employer, Central City Internal Medicine? (What action might her supervisor take against Meredith? Consider what she learned as a new employee)
What should Central City do to ensure these types of problems don’t occur in the future? (Look at it from a perspective of new hires. What should be done so they know this type of action is wrong?)
Rubric for Research Paper
Outstanding – 20pts
Good – 15pts
Fair – 10pts
Unacceptable – 5pts
Excellent section headings, indicative of a steady “flow” to the overall paper. Topics and subtopics clearly indicated.
Good section headings, indicative to a steady “flow” to the overall paper. Topics clearly indicated, could use more subtopics.
Fair section headings, indicative that the paper has “flow”. Topics and subtopics not clearly indicated. Unclear organization of thoughts.
Relevant topics missing or incorrect, paper has no indicative “flow”.
Highly informative, complete and easy to understand. Appropriate vocabulary is used.
Abstract makes you want to read the paper.
Informative, complete and understandable. Appropriate vocabulary is used.
Somewhat informative and understandable.
Not very informative or understandable.
Thesis is clear, easy to find, and appropriate to the assignment.
Thesis is supported by the rest of the paper.
Paper contains a “roadmap” for the reader.
There is a logical “flow” to the topics/arguments. Conclusion follows clearly from the arguments presented.
Thesis is clear and appropriate. Thesis fairly well supported.
Paper is fairly well organized.
Conclusion follows from the rest of the paper.
Thesis is fairly clear.
Inconsistent support for thesis. Paper weakly organized. Conclusion is acceptable.
Thesis unclear and/or inappropriate.
Thesis not supported.
Paper is not organized. Conclusion doesn’t follow from the rest of the paper.
The evidence comes from a wide variety of valid sources. The bibliography is complete and reflects appropriate sources.
The evidence comes from the minimum valid sources. The bibliography is complete.
Valid sources are inconsistently used. The bibliography contains minor formatting errors.
Multiple sources cited incorrectly.
Arguments are pertinent to the topic.
Arguments are logical, supported with evidence. The key arguments have been made – no major points have been left out.
pertinent to the topic. Arguments are fairly logical and reasonably supported.
Most key arguments have been made.
Arguments are not consistently pertinent, logical, or supported. Few key arguments have been made.
Arguments not pertinent. Arguments rarely, if at
all, logical and supported.
Almost no key arguments have been made.
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