Week 9 Case Study - Healthcare Quality

Read the Department of Justice story, “South Jersey Doctor Charged in Health Care Fraud Billing Scheme.” Then, write a 1–2 page report in which you:

1. Summarize three quality issues in the case that resulted in fraudulent billing and coding.
2. Describe three violations that were stated in the case, including how the violations applied based on regulations.
3. Illustrate how this case could be used as a training tool for your organization. You may base your work on the Department of Health and Human Services Office of Inspector General (DHHS-OIG), the Center for Medicare and Medicaid Services (CMS), and the Department of Justice (DOJ) information on quality, fraudulent billing, and so on.