SOLUTION: University of Maryland Global Campus Fraud Case Study

hey! please review the final answer and let me know if you may need further revision.Running Head: Fraud Case1Fraud CaseStudent NameInstitution of AffiliationFraud Case2In the Tampa Bay area, Florida, a medical officer was convicted of bribery and worseneddata theft. The Justice Department released this news. Joshua Maywalt had been a technicalconsultant with a firm providing patient care credentials and billing systems. As per theprosecution, Mr. Maywalt misused his medical officer position by incorrectly obtaining andusing patient details from the firm. He had reportedly been using a physician’s identity andregistration number to make misleading and dishonest medical care requests that were notdirectly given to Florida Medicaid. According to the Department of Justice, Mr. Maywalt alteredthe ‘pay to records shared with the HMO payment processor to make sure payments are delivered tohis banking accounts (Stowell, Schmidt, & Wadlinger, 2018)…The national govt plans to surrenderMr. Maywalt’s $2.2 million houses. The land is possibly traceable by the Department of Justicefor the benefits of the scam.Compliance in healthcare is an ongoing method of complying with legal, ethical, andtechnical healthcare organization requirements. Compliance with health care includes theefficient implementation of processes, rules, and practices for proper behavior to be established,personnel to be educated, and to track compliance with these standards. Compliance withhealthcare covers several sectors: hospital treatment, insurance, reimbursement, managed caresuch as OSHA and HIPAA safety and protection.In addition to demonstrating the contribution of any agency to the full employment oftrained personnel and executives, a more well conformance strategy or program will also supportearly identification and notification of issues such as theft, harassment, or medical negligenceand facilitate efficient communications both administrations and employees.When many firms face already small profits, and as criminal and civil responsibility is apersistent danger, they must optimize all receivables and strive to ensure that their company orFraud Case3their staff are protected from fines, litigation, or some other threat. In this respect, generating andmaintaining the necessary information is essential to the healthcare company’s regulatoryresponsibilities.Equitable documents for contractors are necessary to reduce executive liabilities by, forexample, the Fair Labor Standards Act (FLSA) to ensuring that the organization can meet theconditions of any investigation of DOL, IRS, immigration, or State agency.The ultimate aim and main advantage of complying with health insurance are to increasecare delivery. If healthcare recommendations are made on acceptable and existing scientificguidelines, patient safety can be strengthened. Decisions on patient care based on inappropriatereasons seldom lead to the quality of healthcare.Compliance with healthcare also helps healthcare facilities and suppliers to preventproblems with federal agencies. Until a government body discovers the issue, a successfulhealthcare enforcement program can recognize problems and develop solutions to them. Asuccessful healthcare enforcement policy will also reduce the imposition of fines or punitivemeasures that the healthcare organization/provider may otherwise be penalized.A successful enforcement policy can also help to prevent lawsuits for malpractice by ahealth agency or contractor. The reporting that the company or provider follows existing qualitypractices is a consistent topic in healthcare compliance. A company or provider of healthcarewho practices best is much not likely to be convicted of a misconduct allegation.Fraud Case4Potential criminal and monetary fines for violating healthcare compliance practices.Penalties for civil violationsFor violation of knowledgePenalty range: 100-50,000 dollars per offense, with a limit of 25,000 dollars annually for repeatviolations.Reasonable breach of a cause,Penalty range: $1,000-$50,000 per infringement, up to $100,000 annually for repeat offences.Intentional negligence, but breach within the appropriate time frame is corrected.Scope of penalties: $10,000 to $50,000 each offense, with an average limit of $250,000 perviolation.Willful negligence will not be resolved within the time needed.Penalty vary: $50,000 each infringement, up to $1.5 million annually.For Criminal penalties, agencies such as the DOJ will deal with criminal violations. As inthe HIPAA civil fines, the seriousness of drug offenses is distinct. Covered agencies and personswho “informally” procure or report identifiable health data are subject to a fine of up to $50,000as well as jail terms of up to 1 year over Administrative Simplification Regulations. Crimesunder false identities cause fines to be raised to even a $100,000 penalty, including a jail term ofup to five years. In conclusion, offenses have done for financial benefit, self-benefit, orintentional damage to sell, pass or use identified human medical records allow fines up to$250,000, including jail terms of up to ten years.Fraud Case5Financial compliance measure to prevent the occurrence of fraud;Establishment and implementation of written policy and guidelines to encourage action by thecompany.Identification and assignment within a person responsible for overseeing compliance activitiesand enforcement of practical requirements as a compliance officer. Establishment of monitoringmechanisms to allow persons to protest without fear of punishment concerning enforcementproducts.Commitment to standardized educational plans for all types of workers. Continuous frameworkaudit and review to determine enforcement policy efficiency and to detect problems.Develop plans to impose corrective action on staff that does not meet the criteria. In the event offlaws, disciplinary steps must be taken in reaction to possible breaches.Loopholes in the applicable law or the system the perpetrators use to commit the fraudinclude:A data breach of electronic data is becoming a major issue in all sectors, but it can beparticul…

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