Read Maryland Health Care Provider Sentenced to 10 years in Federal Prison for Health Care Fraud Resulting in Patient Deaths from the United States Attorney's Office.Use the 5 Whys to conduct a root cause analysis to determine why the Medicare fraud occurred and Timothy Emeigh’s participation in the case.Write a 525- to 700-word paper that identifies and evaluates the root cause for Medicare fraud in this case.Include the following:List each of the 5 Whys and your response.Speculate as to why Mr. Emeigh participated in the scheme.Explain what you might have done to prevent this from happening.Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

Activity 1National Health Coverage Plans, Reimbursements, and QualityBaccalaureate education includes learning opportunities of healthcare policy, finance, and regulatory environments (AACN, 2008). Complete the Nursing Quality Indicators (NQI) virtual simulation activity to explore the impact of nursing designs on quality measures, including cost, systems, processes, and outcomes of various points of care. The goal of this activity is to think about basic quality and safety investigations that are used to create and measures outcomes of quality improvement processes.Please Note: You can navigate to the NQI activity by clicking on 'Sentinel Hospital', entering the lobby, and clicking the brown icon: 'Surgical Services. Introduction & Healthcare Coverage and Vulnerable Populations Describe the importance of healthcare coverage (insurance). End with a clearly worded purpose statement for this project. Discuss two ways healthcare coverage is beneficial (helpful) for the vulnerable/ uninsured populations.Diagnosis Related GroupsDescribe the purpose of Diagnosis Related Groups (DRGs). Explain the impact of DRGs on length of stay and payment of services. Discuss how payments for DRGs are now impacted by quality indicators and measures.Select a Major Healthcare Plan(Label heading with the name of the plan Ex: Preferred Provider Option Plan) Select one of the patients from the cases you reviewed in NQI. Summarize two care options provided by the plan that facilitates access for your selected patient. Summarize two care options that limit access to care for your selected patient.Select a Second Major Healthcare Plan(Label heading with the name of the plan Ex: Medicaid) Repeat this activity with the same patient. Summarize two care options provided by the second plan that facilitates access for your selected patient. Summarize two care options that limit access to care for your selected patient.Impact of Nursing InterventionsSummarize at least four priority nursing interventions or considerations to promote self-care for your selected patient to provide high quality, safe healthcare considering nursing-sensitive indicators. Provide a rationale for each of your selected nursing decisions.ConclusionSummarize the key points of your project.**You will not discuss the deductibles or costs of the insurance plans as this is not the focus of this this assignment.Following the simulated activity, you will examine the relationship between healthcare coverage (insurance), quality care, and reimbursements (payments) to health care organizations. Select two different major national (U.S.) insurance health plans. You may choose Medicaid, Medicare, HMO, PPO, or private insurance plans. You can choose your own personal insurance plan if you prefer. Review healthcare coverage options offered by both plans that benefit (facilitate) and hinder (limit) access to care. Examples of healthcare coverage (insurance) options that facilitate, or limit access include medication coverage, primary care physician office visits, specialists physician office visits, emergency care, lab or blood work and diagnostics, wellness care, prevention services or surgery (these are just a few examples). You will also explore the role of Diagnosis Related Groups (DRGs) and charity care within healthcare facilities (hospitals) and how charity care impacts the vulnerable or uninsured population. Finally, summarize nursing interventions or considerations for your selected patient to provide high quality, safe healthcare considering nursing-sensitive indicators in his/her unique scenario.Textbook and other resourcesCenters for Medicare and Medicaid Additional Instructions:and Quality Description: The baccalaureate-graduate nurse will compare the benefits and limitations of major forms of reimbursements on the delivery of health care services, advocate for vulnerable populations, and describe how health care is organized and financed, including system cost factors. Course Competency(ies): 1) Critique key health priorities and goals from a national and global perspective. 3) Examine the effect of health and social policies on persons with diverse ethnic and cultural backgrounds. 5) Construct nursing interventions that provide high quality, safe healthcare using nursing-sensitive indicators. QSEN Competency(ies): 1) Patient-Centered Care 2) Teamwork and Collaboration BSN Essential V Area Gold Mastery Silver Proficient Bronze Acceptable Acceptable Mastery not Demonstrated Describes the purpose and importance of the healthcare coverage (insurance). End paragraph with a clearly worded purpose statement. Describes the purpose and importance of healthcare coverage (insurance). End paragraph with a clearly worded purpose statement. Describes the purpose and importance of healthcare coverage (insurance). Some details are missing. Purpose statement is unclear or not. Does not explain the purpose and importance of healthcare coverage (insurance). Some content is missing. No purpose statement. Does not address section Describes the purpose of Diagnosis Related Groups (DRGs). Explains the impact of DRG’s on length of stay and payment of services. Discusses how payments for DRGs are now impacted by quality of care. Describes the purpose of Diagnosis Related Groups (DRGs). Explains the impact of DRG’s on length of stay and payment of services. Discusses how payments for DRGs are now impacted by quality of care. Provides details Minimally describes the purpose of Diagnosis Related Groups (DRGs). Minimally explains the impact of DRG’s on length of stay and payment of services. Minimally discusses how payments for DRGs are now impacted by quality of care. Some details are missing. Simply describes the purpose of Diagnosis Related Groups (DRGs). Simply explains the impact of DRG’s on length of stay and payment of services. Simply discusses how payments for DRGs are now impacted by quality of care. Some content is missing. Does not address section Select a Major Healthcare Plan Fully summarizes two care options provided by the plan that facilitates Minimally discusses two care options provided by the plan that Simply discusses one care option provided by the plan that facilitates Does not address section Label heading with Name of Plan - EX: Preferred Provider Option Plan) Summarize two care options provided by the plan that facilitates access for the patient. Summarize two care options that limit access to care for the patient. access for the patient. Fully summarize two care options that limit access to care for the patient. Provides details. facilitates access for the patient. Minimally discusses two care options that limit access to care for the patient. Some details are missing. access for the patient. Simply discusses one care option that limits access to care for the patient. Some content is missing. Select a Second Major Healthcare Plan and Label Heading with the Name of the Plan Summarize two care options provided by the plan that facilitates access for the patient. Summarize two care options that limit access to care for the patient. Summarizes two care options provided by the plan that facilitates access for the patient. Summarizes two care options that limit access to care for the patient. Provides details. Minimally discusses two care options provided by the plan that facilitates access for the patient. Minimally discusses two care options that limit access to care for the patient. Some details are missing. Simply discusses one care option provided by the plan that facilitates access for the patient. Simply discusses one care option that limits access to care for the patient. Some content is missing. Does not address section Summarize at least four priority nursing interventions or considerations to promote self-care for your selected patient to provide high quality, safe healthcare Summarizes at least four priority nursing interventions or considerations to promote self-care for your selected patient to provide high quality, safe healthcare considering Summarizes at least three priority nursing interventions or considerations to promote self-care for your selected patient to provide high quality, safe healthcare considering Summarizes at one to two priority nursing interventions or considerations to promote self-care for your selected patient to provide high quality, safe healthcare considering considering nursing-sensitive indicators. Provide a rationale for each of your selected nursing decisions. Ends paper with a separate paragraph (with Conclusion as heading) and summarizes key points in paper. nursing-sensitive indicators. Provides a rationale for each of your selected nursing decisions. Ends paper with a separate paragraph (with Conclusion as heading) and fully summarizes key points in paper. nursing-sensitive indicators. Provides a rationale for three of your selected nursing decisions. Ends paper with a separate paragraph (with Conclusion as heading). Conclusion paragraph is unclear. Some key points are missing. nursing-sensitive indicators. Provides a rationale for each of your selected nursing decisions. Conclusion paragraph is missing. APA, Grammar, Spelling, and Punctuation No errors in APA, Spelling, and Punctuation. One to three errors in APA, Spelling, and Punctuation. Four to six errors in APA, Spelling, and Punctuation. Seven or more errors in APA, Spelling, and Punctuation. References Provides three or more references. Provides two references. Provides one references. Provides no references.