The Affordable Care Act (ACA) was aimed at improving our health care system in three main area. These include expansion of consumer protections, reducing the health care costs, and strengthening Medicare. ACA institutes different measures, new rules, and tougher sentences for crimes related to abuse, fraud, and waste. The prevention of fraud, abuse, and waste is not only the responsibility of the government agencies but also involves the providers and suppliers (Clemente et al., 2018). One of the measures that are being implemented in my health care organization is enforcing strict billing policies. The organization focuses on improving the medical billing and coding processes. This is because the clinical documentation is used the basis upon which payers reimburse providers for their services (Clemente et al., 2018). The organization implemented electronic documentation as a second measure for preventing fraud and abuse. Inappropriate and inaccurate coding and documentation can lead to potential health care fraud and abuse investigations. In addition, the facility has enforced stringent screening and enrollment requirements for new providers and suppliers. The procedure involves screening processes for medical providers and suppliers including licensure checks, fingerprinting, and criminal background checks to assess the integrity of the providers and supplier (McGee, Sandridge, Treadway, Vance, & Coustasse, 2018s.

References

Clemente, S., McGrady, R., Repass, R., Paul III, D. P., & Coustasse, A. (2018). Medicare and the affordable care act: fraud control efforts and results. International Journal of Healthcare Management, 11(4), 356-362.

McGee, J., Sandridge, L., Treadway, C., Vance, K., & Coustasse, A. (2018). Strategies for fighting Medicare fraud. The Health Care Manager, 37(2), 147-154. doi:10.1097/hcm.0000000000000204

Using the information from the interview you conducted in Week 2 (Document Attached)

In a Microsoft Word document of 4-5 pages formatted in APA style, describe the information collected about the person with a chronic illness from week 2.

·  List the support needs of your participant beginning with the highest priority and then in descending order.

·  Provide examples of appropriate interventions of the professional caregiver, for example, the nurse.

·  Discuss how to implement objectives of Healthy People 2020 to increase wellness.

·  Discuss nursing’s role as an advocate for participant acceptance of diagnosis and treatment.

·  Discuss the impact of the environment on patient’s health.

Include social determinants that impact care.

Support your responses with examples.

Please note that the title and reference pages should not be included in the total page count of your paper.

On a separate references page, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the  University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the  University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

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