Medicare Compliance: Fraud and Abuse (CE: 0.5)

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.

• 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.