Physician Billing and Modeling changes in Medicare reimbursement health and medicine homework help

Need help with the following 2 assignments. I have uploaded 3 documents (the entire case study, readmission information, and additional info) to assist with this. The book this came from is Introduction to the Financial Management of Healthcare Organizations, 6th edition by Micheal Nowicki.

1. US attorneys are reviewing our billing practices and physician relationships. Explain to me what they’re looking for and whether you think we have any liability. What actions have been brought against hospitals like ours during the last 2 years? Do we need a corporate compliance plan and, if so, what should it include? Do rural hospitals get any breaks in dealing with physicians?

2. I need your analysis of three Medicare initiatives. First, Medicare keeps threatening to cut physician payments. give me the history of this threat; the likelihood this cut will happen and how you think physicians will be reimbursed by Medicare in the future; and what you think physicians will do in reaction, including the possible effect on our hospital. Second, is it true that Medicare will no longer pay for healthcare-associated infections and readmissions? How much revenue will we lose and what should we be doing now in preparation? And third, how much have hospitals, and our hospital in particular, lost in Medicare reimbursement since 2010?

 

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