Profit health care organization

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Working in the billing department for a large, for-profit health care organization has been a dream come true for Nicki Knowitall and she is excited about her future opportunities. Nicki has been with the company for two and a half years and was just promoted to senior Medicare Billing Specialist. Since Nicki has been dealing with Medicare for over two years, she jumps right in and continues with the same billing practices she has been using and trains her staff with these techniques.Because Nicki’s new position allows her to view information that she was not previously privy to, she has started to notice some discrepancies surrounding the way many of the Medicare invoices are coded. She pulls several of these invoices and shows them to her supervisor. The supervisor informs her that this is how they will continue to code these documents and that Ms. Knowitall should focus solely on training and monitoring her staff. Nicki finds the response she received to be very strange, but nevertheless, she goes back to her work.Six months pass and Nicki has grown more distraught as she has collected literally thousands of invoices that are coded incorrectly, but there is nothing she can do to change them at her level. She does not feel comfortable approaching her supervisor again, and she is concerned that going higher up the chain of command may make it even worse. To compound the problem, Nicki reads in the local paper that another facility in the system that she works in is being investigated for Medicare fraud.
Should Nicki quit her job, speak to her supervisor, and/or go over her head to others in the chain of command? Explain and cite reasons for your answers.Nicki has kept thousands of documents that she believes are fraudulent in nature. What should she do with these? Should she provide them to her supervisor? The media? Why or why not?What laws, if any, are you familiar with that may help to protect Nicki? Explain your answer and detail the provisions of these laws.In your mind, does this case present an issue of fraud, abuse, or both? Explain.Pretend that you are Nicki. You want to do the right thing, but you aren’t sure what that is. Where do you start? Outline a path for Nicki to follow.
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In December 1978, Gacy meets Robert Jerome Piest, a 15-year old kid working at a drug store and extends to him an employment opportunity at Gacy’s firm. Piest illuminates his mom regarding this and neglects to restore that night. The Piest family documents a missing individual’s report and the drug specialist educates police that Gacy would undoubtedly be the man that Jerome addressed about work. When addressed by the police, Gacy denied any contribution in Piest’s vanishing. Nonetheless, the police were not persuaded, and Gacy’s history of sexual maltreatment and battery provoked the police to look through his home. Among the things found at Gacy’s home were a 1975 secondary school class ring with the initials J.A.S., numerous driver’s licenses, cuffs, apparel that was unreasonably little for Gacy, and a receipt for the drug store that Piest had worked at. Through the span of the following hardly any days, specialists got various calls and tips about Gacy’s rapes and the puzzling vanishings of Gacy’s representatives. The class ring was inevitably followed back to John A. Szyc, one of Gacy’s casualties in 1977. Futhermore, after looking at Gacy’s vehicle, examiners found a little bunch of filaments taking after human hair, which were sent to the labs for additional investigation. That equivalent night, search hounds were utilized to recognize any hint of Piest in Gacy’s vehicle, and one of the canines demonstrated that Piest had, truth be told, been available in the vehicle. On December 20, 1977, under the pressure of consistent police reconnaissance and examination, Gacy admits to more than 30 homicides and educates his legal advisor and companion where the bodies were covered, both in the slither space and the waterway. 26 casualties were found in the slither space and 4 in the waterway. Gacy is captured, indicted for 33 killings, and condemned to death by deadly infusion. He endeavored a craziness request yet was denied, and was executed on May 10, 1994. There were a few criminological markers that agents used to attach Gacy to the killings. A portion of these include fiber examination, dental and radiology records, utilizing the disintegration procedure of the human body, and facial reproduction in recognizing the people in question. Examiners discovered filaments that looked like human hair in both Gacy’s vehicle and close to the creep space where the bodies were covered. Notwithstanding these hair tests, specialists additionally discovered filaments that contained hints of Gacy’s blood and semen in a similar territory. Blood having a place with the casualties was found on a portion of the filaments, which would later straightforwardly attach Gacy to the violations. The filaments in Gacy’s vehicle were broke down by measurable researchers and coordinated Piest’s hair tests. Moreover, the hunt hounds that confirmed that Piest had been in Gacy’s vehicle showed this by a “demise response”, which told examiners that Piest’s dead body had been within Gacy’s vehicle. Out of Gacy’s 33 known casualties, just 25 were ever convincingly distinguished. A significant number of Gacy’s casualties had comparable physical portrayals and were along these lines hard to distinguish by absolutely asking general society. To distinguish the people in question, specialists went to Betty Pat Gatliff, a pioneer in criminological science and facial reproduction. Facial remaking is the way toward reproducing the facial highlights of a person by utilizing their remaining parts. Certain facial highlights, for example, facial structures, nasal structure, and generally face shape can be valuable in distinguishing a casualty even long in the afterlife. By utilizing these highlights, and with the assistance of program, measurable specialists can make a picture of an individual’s face, which is instrumental in distinguishing casualties after their bodies have rotted. Facial reproduction should be possible in a few measurements. Two-dimensional facial reproductions is utilized with skull radiographs and depend on pre-demise photos and data. Notwithstanding, this isn’t really perfect on the grounds that cranial highlights are not constantly noticeable or at the correct scale (Downing). So as to get a reasonable and increasingly precise delineation of the casualty’s face, a craftsman and a scientific anthropologist are typically important (Downing). Three-dimensional facial remaking is finished by figures or high goals, three-dimensional pictures. PC programs can make facial reproductions by controlling checked photos of the remaining parts and use approximations to reproduce facial highlights. These will in general produce results that don’t look counterfeit (Reichs and Craig 491). In some cases, specialists will utilize a strategy called superimposition as a method for facial reproduction. Sadly, it’s anything but a usually utilized strategy, as it expects agents to have some information about the character of the remaining parts they are managing. By superimposing a photo of a person over the skeletal remains, examiners can check whether the facial highlights line up with the anatomical highlights, permitting them to recognize a casualty. On account of John Wayne Gacy’s casualties, specialists had the option to utilize facial reproduction to distinguish nine of the bodies found in the creep space. The accompanying realistic shows the facial reproductions of these nine casualties: Since facial recreation was insufficient to recognize the entirety of the people in question, examiners acquired DNA profiles from every one of the unidentified casualties and effectively searched out DNA tests from guys over the United States who had been accounted for missing somewhere in the range of 1970 and 1979 (Cook County Sheriff’s Office 3). The rest of the casualties were recognized utilizing dental and radiology records.>

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