Find actions when up-coding has taken place


You have just been hired as the special assistant to the regulatory compliance officer (RCO) at Union Hospital, a large community hospital. The RCO recently received confidential information from a hospital employee that some up-coding may be occurring in the hospital. The RCO has asked you to prepare a memorandum that covers the following topics: What is up-coding? What statute might it violate? In general terms, what are the penalties for violation of the federal fraud and abuse statutes? The employee has threatened to bring suit himself if the RCO does not address the situation; can he do that? If you determine that up-coding has taken place, what actions would you recommend with respect to "fixing" the problem and addressing the behavior of the individuals involved.

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Microeconomics: Find actions when up-coding has taken place
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