You lead a multi-disciplinary team that deals with compliance issues for GoodHealth, Inc., a large healthcare provider that owns four hospitals. Your team did some investigating, including internal audits and confidential interviews, and they found the following:
(1) the provider seems to have imposed budgetary constraints that they knew or should have known would prevent facilities from providing adequate care;
(2) care that is not of acceptable quality is being provided;
(3) there are medical coding errors going five years back that will likely total millions of dollars;
(4) medical errors are not being consistently reported; and,
(5) physician peer review for medical errors is not taking place in a consistent or timely manner.
Your team has concluded that it is in the best interest of GoodHealth, Inc. to self-report to the OIG. The team must prepare a paper and presentation for the CEO. The CEO will submit the paper to the Board of Directors. Be creative. How should this be approached?
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