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Discussion 3: Fraud, Abuse, and Penalties

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Please post to the Discussion Board your response to the following:

In a 200 words answer the following questiosn

1.Why should hospitals and physicians be concerned about ownership of medical practices, hospitals and other medical services?

2. List at least 3 laws or regulations that would govern such concerns if they exist.

3. Whom do these laws cover and how do they protect patients?

David · Accepted Answer

Question 1 
Why should hospitals and physicians be concerned about ownership of medical 
practices, hospitals and other medical services? 
The most important consideration on why there should be so much concern on ownership of 
medical practices, hospitals and other medical services is creation of a win-win situation for both 
the entities i.e. hospitals and physicians. Physicians can earn their salaries without the burden of 
administrative responsibilities while the hospitals can increase revenue streams and also receive 
new referrals from new staff and doctors. Another important concern of physicians’ stems from 
the need to report to those doctors who do not possess required expertise and counter their 
recommendations. Secondly, lack of any internal career path in private practice is also a concern 
for many physicians. Moreover, physicians are constrained to make lesser money whenever 
there is a need for equipment replacement and physicians are slow to give response to capital 
expenditure requirements as they will balance these requirements against revenue generation 
from the expense. Moreover, physicians can have conflicting priorities and can be competing 
against each other. Also a hospital might out rightly purchase the practice and the physician can 
either find himself out of job or having his job role changed altogether. On the other hand, in a 
hospital, the physician might as well be reporting to a management professional who knows the 
business and supports the physician’s well researched recommendations. There will be support 
coming from other section of the hospital like HR department professionally screening the staff 
working under the physician and providing the much needed orientation. The IT department will 
not only maintain associated software and hardware systems but the physician’s practice 
management system, and the Emergency management response system and finally there will be 
support coming from accounting department who will take care of the bills and payroll 
requirements. There will be a set career path for the physician and opportunities to rise up the 
career ladder like head of the hospital etc. There will be ample scope of interaction with other 
departmental managers that will widen physician’s knowledge about other areas of hospital. 
However,

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