BHS 499 (Senior Capstone Project) Module 3 CBT Essay

BHS 499 (Senior Capstone Project) Module 3 CBT - Essay Example Fraud as defined by the Merriam-Webster Dictionary of Law is "any act, expression, omission, or concealment calculated to deceive another to his or her disadvantage; specifically: a misrepresentation or concealment with reference to some fact material to a transaction that is made with knowledge of its falsity or in reckless disregard of its truth..." The HIPAA or Health Insurance Portability and Accountability Act of 1996 defines it as ''a criminal conspiracy or a violation" to specific provisions indicated in the U.S. Code which pertains to conspiracy relating to a health care benefit program'' 18 U.S.C. x 24(a). Furthermore, fraud is basically considered as an act of misrepresentation or deception designed to acquire something of value held by some other; and the most common forms of fraud among nurses documented by CNO include: falsifying a record; collecting pay under false pretenses; misappropriating property or money through deceptive means; and providing false information to ones employer (Quality Practice, 2003; p 1). Below outlines the managerial, legal, ethical and financial implications brought about by fraudulent and financial abuse in the health care industry. The unnecessary patient treatments that are being ordered, limits the patient's coverage which may be subsequently met prematurely; later, patients may not be able to expend co-payments for gratuitous visits. In addition, false diagnoses for the purpose of up-coding may affect the patient's ability to obtain maintain insurance coverage since the information is available primarily to other potential insurers (Busch, 2007).According the National Health Care Anti-Fraud Association, around $56.7 to $170 billion is the estimated loss annually (Department of Health and Human Services, 2005). Centers for Medicaid & Medicare (2006) expressed that the dollars lost to reimbursement of Medicare and Medicaid as well as intentional improper billing could have been used to fund the health insurance of low-income persons; if they were not acquired or end up in the pockets of the unscrupulous health care suppliers and providers. The Provision 3.5 under the Code of Ethics calls upon that all nurses needs to take appropriate action about any instances of unethical, incompetent, illegal or impaired practice by members of the health care team or any action on the side of others by the health care system which places the best interest of the patient (American Nurses Association, 2001). Fletcher, Sorrell, and Silva (1998) have point out that nurses are frequently called upon to make sacrifices, in their personal as well as professional, ones they adhere strictly to Nurses' Code of Ethics. This code 3 requires nurses' accountability as professionals however fails to acknowledge that the reality is that in the health care system, many nurses have limited power within. Job security for fraud investigators and auditors remains strong. Over the years, it continues to attract the nurses who are ethically challenged. Health care fraud is oftentimes buried within the functions in critical business. In 2006, initiatives were made to implement the development of health information technology infrastructure, in order to improve the

Mergers and acquisitions Coursework Example | Topics and Well Written Essays - 2500 words - 1

Mergers and acquisitions - Coursework Example This paper seeks to examine examples of companies in the USA that were involved in a merger. Mergers often look forward to ensuring profits rather than losses in the business combination. The selected company that involved itself in a merger is the Continental Airlines Company. The company was involved in the merger with another airline company. The two companies were the entities in the merger. An entity in business or in mergers and acquisitions (M & A) describes the organization, company or corporation that is acquired by another organization, company or corporation or that merges with the other in order to ensure a successful business in terms of profits, quality of products and competition and its continuous and long term survival in the world's competitive markets (Harwood, 2005). In the year 2010, an airline company in the U.S, Continental Airlines, merged or was rather acquired by another company, United Airlines (UAL) Corporation, also an airline holding company in the U.S w hich had its headquarters in Chicago in the state of Illinois. The two airline companies merged to form the United Continental Holdings in October 2010. The merger took place to ensure that the new company founded posed stiff competition to other airline companies around the world. The merge was also to ensure better services than the services provided before by the individual airline companies. After merging, the founded airline, United Continental Holdings became the largest airline company in the world as was confirmed by revenue passenger miles (New York Times, 2010). Mergers and acquisitions are often accompanied by transaction prices and payment terms. At the time of the merger between Continental Airlines and UAL Corporation, there were several factors that were involved in determining the transaction price and the payment terms for each of the individual companies after the merger. The first factor that determined the payment terms was the presence of other potential bidders who would provide better payment terms. United Airlines initially held merger talks with the US Airways. It is said that a deal was close between the two companies (New York Times, 2010). Unfortunately the merger talks broke off paving way for talks between the United Airlines Corporation and other airlines. On the other hand, the Continental Airlines also held merger talks with the Star Alliance and even merged. However the two airlines later on separated. This paved way for merger talks between the Continental Airlines and the United Airlines Corporation. Better payment terms were put in place bearing in mind that there were other potential bidders in case of a break off of the merger talks. The second factor that determined the transaction price and the payment terms between the two companies was the share deal that was signed by both entities. When the United Airlines and the Continental Airlines announced their merger in 2010, they struck so many deals. One was of a new name o f the company to be formed which was named the United Continental Holdings. Secondly, the two companies struck deals to share the losses and profits. This share deal was the key factor which was strongly involved in determining the transaction price and payment terms during their merger. The third factor that determined the transaction price and the payment terms was the taxes to be imposed on the newly formed company by the US government. Taxes imposed on a certain company greatly influences the payment terms. In case of friendlier taxation, the two entities could enjoy sharing in large amounts of the profits incurred. However, in case of harsh taxation by the US governm