In healthcare, federal and state laws including, but not limited to the HealthCare Fraud Statute, False Claims Act and Red Flags Rule address different components of fraud. In health information technology, an important component is policies and procedures to monitor abuse or fraudulent trends.
Part 1: Research the Health Care Fraud Statute and prepare a procedure to monitor abuse or fraudulent trends.
Part 2: In this week’s reading we discuss systems selection and contract management. For your assigned option, review the New York State Office for People with Developmental Disabilities (OPWDD) Division of Service Delivery Request for Proposal Clearinghouse RFP.
Option 1: Section 1 and Section 2
Option 2: Section 3 (3.1 through 3.2.16)
Option 3: Section 3 (3.3 through 3.17)
Option 4: Section 7 and Section 8
For your assigned sections, review the request for proposal (RFP). Assume your organization requested you to review the RFP for clarity and content. Identify three areas that are well-developed and appropriate for the RFP and explain why you chose those three areas. Identify three areas that you are unfamiliar with the terminology or feel the RFP is unclear or incomplete and explain why you chose those three areas. For your assigned section(s), develop three sample criteria for differentiating vendor responses to the RFP.