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Working in the billing department

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.

Sample Solution

g Saudi Arabia. Evidently, oil is one of Venezuela’s most valuable commodities accounting for 95% of Venezuela’s exports and 25% of its gross domestic product (Independent 2018). However, during a period of time in which the global price of oil dropped, foreign demand to buy Venezuelan oil dipped simultaneously. A key factor that lead to Venezuela’s current crisis, is evidently their sole dependence on a single commodity – oil. As University of Florida’s Gamarra explains, this means “you are bound to the ups and downs of the oil price,”. Without a range of high value added assets, an economy lacks diversity and is vulnerable to ‘moments of downturns in your principal commodities (CNBC 2019).’ On an individual basis, hyperinflation renders any savings worthless due to its eroding impact on money. Consequently, people may hoard goods for instance, food due to the soaring prices. Situations such as these may lead to shortages of food supply, contributing to the issue further. The Bolívar (Venuzuelan currency) depreciated in value as the cost of imports increased, leaving the Venezuelan economy to perish. Consequently, Nicolas Maduro – Venezuela’s new president – decided to print money (TheConversation 2019). Although this is an efficient strategy to implement during times of temporary price shock, in the case of Venezuela, the desired results didn’t adhere. Alongside the price of oil continuing to decrease, Venezuela’s oil output also fell resulting in international investors looking elsewhere further decreasing the value of the Bolívar. The government proceeded to print off more money in order to pay their expenses, inevitably resulting in the cycle that lead to hyperinflation (TheConversation 2019). To begin with, whether or not inflation is always deemed to be a challenge or if there are actually any potential benefits surrounding the macroeconomic issue will be discussed. Generally speaking, moderate inflation has some benefits, especially when it’s compared to deflation. For instance, the real value of debt decreases, moderate rates also enable prices of goods to adjust to their real value prices. In some cases, at levels of moderate inflation, companies are able to increase wages whilst the prices of goods increases. However, the average inflation target is usually around 2% which is quite contrasting to that of Venezuela’s. Long term economic growth is thought to be optimised when price stability is maintained, which is done by controlling inflation (Investopedia 2019). At the level of inflation currently being faced by Venezuela, it is more suitable to refer to it as hyperinflation – a more extreme inflation during which price increases are uncontrollable and the value of money erodes to the extent that it is rendered worthless (thebalance 2019). Under these circumstances, few people benefit, however, debt holders and individuals who had taken out loans are amongst those who do, as inflation has the effect of eroding debt. Depending on the spread and severity of the inflation, the increase in prices ma
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