The Patient Protection and Affordable Care Act (PPACA) of 2010 (section titled “Subtitle D”) identifies requirements relating to provider compliance with fraud, waste, and abuse laws. Identify three measures that your health care organization ((or health care organizations in general) has initiated, or could initiate, to comply with these measures. Support your analysis with a minimum of two peer-reviewed articles. Support your response with a minimum of three peer-reviewed references. 

A comprehensive compliance plan could be one of the first steps my healthcare organization or other health care providers can take to ensure they comply with Patient Protection and Affordable Care Act, 2010 (PPACA). According to a report by the American Health Lawyers Association, this plan should include “policies and procedures for detecting, preventing, and responding to fraud, waste and abuse” that are tailored specifically for each organization’s unique circumstances (AHLA 2019). The plan should be subject to periodic audits, as well as steps to ensure that employees are properly trained in relevant policies. This preventative protocol can ensure compliance within organizations and minimize the risk of legal action for incorrect billing or other improper handling.

Another option for health care providers is to establish a program that detects fraudulent practices or activities before they happen. Monitoring various operations such as employees behavior, billing charges and patient outcomes to spot possible irregularities in order to take corrective actions. In terms detection strategies article published Journal Fraud & Abuse notes use analytics within healthcare settings which involves sifting through large amounts historical clinical financial data detect patterns indicative suspicious transactions alert responsible personnel before actual wrongdoing takes place  (Lane et al 2017).

Organizations can also comply with PPACA rules by following disclosure requirements for any disciplinary actions against staff members. This may sound simple, but certain situations are more complex than others.

It is important to have an understanding of laws regarding fraud and waste in healthcare. This will ensure that all institutions are compliant.