Medicare Compliance
Fraud & Abuse Training

This interactive online training course for your managers and staff to help protect your organization from fraud and abuse charges by detailing employer and employee responsibilities in preventing and identifying fraud and abuse.

Medicare Compliance Online Training Course

Medicare Compliance: Fraud and Abuse

Financial losses from fraud and abuse cost approximately $300 billion annually. This course provides an overview of the principle laws used to combat fraud against government healthcare programs; the False Claims Act, Anti-kickback statute, and the Stark Law and also the communication mandates from The Deficit Reduction Act. The course also details employer responsibilities in preventing fraud through establishment of compliance programs and employees’ responsibilities in identifying and preventing fraud and abuse in the workplace including whistleblower activities and protections.

Who Should Take This Course

This course was developed for all employees and level of management working in healthcare organizations who need to know the fundamental rules rules regarding healthcare fraud and abuse.

What is Covered

This course provides a review of the laws that are used to combat fraud and abuse against government healthcare programs including:

  • False Claims Act - 31 USC ss 3729 (FCA)
  • Anti- Kickback Statute - 42 USC 1320-7b(b)
  • Physician Self-Referral (“Stark”) Statute - 42 USC 1320-7b(b)
  • Fraud Enforcement and Recovery Act of 2009 ("FERA")
  • Patient Protection and Affordable Care Act
  • Deficit Reduction Act of 2005 (DRA)

Course Objectives

  • Describe the differences between healthcare fraud and abuse.
  • Describe the principle laws that are used to combat fraud and abuse against federal government healthcare programs.
  • Identify the elements of healthcare fraud.
  • Describe a compliance plan so employers can prevent false claims.
  • Describe how employees can avoid False Claims Act violations.
  • List the role of whistleblowers in False Claims Act suits and how they are protected.

Course Lessons:

  • Lesson 1 - Introduction and Objectives
  • Lesson 2 - Defining Fraud and Abuse
  • Lesson 3 - Laws Combating Healthcare Fraud
  • Lesson 4 - Compliance Plans and how Employees Can Prevent False Claims Act violations
  • Lesson 5 - Role of Whistleblowers in False Claims Act suits

Key Course Features:

  • Clear Course Objectives
  • Engaging & Relevant Animated Scenarios
  • Audio Narration
  • Relevant Use of Graphics and Text
  • Section Review Questions
  • End of Course Assessment - 80% passing score
  • Test questions randomly pulled from question pool
  • Certificate of Completion
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