Medicare fraud and abuse training
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Medicare: Fraud & Abuse and Corporate Compliance Training

In the fast-paced and complex healthcare environment, with growing patient loads, it can be easy for employees to forget all the rules governing proper billing and coding practices and what actions may be deemed as fraudulent or abusive and violate the key laws that are used to combat fraud and abuse against federal government healthcare programs. At Evolve e-Learning, we grow with technology to make compliance training easy and keep your company up-to-date on the key laws and practices that impact proper billing to government healthcare programs. Contact us today or browse review the courses below to include in your organizational compliance training program.

Combine these OSHA training courses along with our OSHA for healthcare, HIPAA Privacy & Security, and HR/EEO anti-harassment courses to create your own training bundle and a fully compliant workplace.

Deliver these courses on our Workplace LMS developed to compliance training or your own LMS.

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Course Features and Benefits

  • Clear course objectives provide a roadmap, enhance focus and improve engagement with the courses.

  • Generative AI for videos and audio narration to promote learner engagement and interactivity.

  • Course bookmarking so learners return to the same course page when they re-launch a course.

  • Restricted course navigation to ensure learners view all course material.

  • Non-graded knowledge checks, scenarios and/or exercises that reinforce learning and retention.

  • Ten questions are presented in the end of course assessments pulled randomly from test question bank.

  • Learners have unlimited opportunities to pass the assessment after achieving less than minimum passing score.

View Medicare: Fraud and Anti-Bribery Courses Descriptions below

Combine these OSHA training courses along with our OSHA for Healthcare, HIPAA Privacy & Security, and HR/EEO anti-harassment courses to create your own training bundle and a fully compliant workplace.

This Medicare fraud and abuse 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.

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)

License both the Medicare Compliance: Fraud and Abuse and the HIPAA Privacy and Security for Covered Entities training courses for a reduced license fee over individual course purchase. Give your staff the tools they need to protect your organization against disclosure of protected health information and reduce the risk of fraud and abuse. These mobile compatible courses deliver the training with audio, animations, lesson knowledge checks and end of course assessments. Learners receive a printable certificate of completion after completing and passing each course. This bundle includes:

  • Medicare: Fraud & Abuse
  • HIPAA Privacy & Security for Covered Entities
Corporate Compliance

Staying compliant with the Foreign Corrupt Practices Act (FCPA) is about more than just memorizing laws. No one knows that better than the many US companies that have paid tens or hundreds of millions in fines and settlements for violations of the FCPA. When it comes to anti-bribery and corruption, employees need to understand not just what the laws are, but why they matter, and how to handle grey-area situations they might encounter in real life. Our anti-bribery training is intended to help your team avoid FCPA violations.

License both Medicare Compliance: Fraud and Abuse and HIPAA Privacy and Security for Business Associates training courses for a reduced license fee over individual course purchase.  Give your staff the tools they need to protect your organization against disclosure of protected health information and reduce the risk of fraud and abuse. These mobile compatible courses deliver the training with audio, animations, lesson knowledge checks and end of course assessments. Learners receive a printable certificate of completion after completing and passing each course.   This bundle includes:

HIPAA Certification

Differences Between “Fraud” and “Abuse”.

There are differences between fraud, waste, and abuse. One of the primary differences is intent and knowledge.

  • Fraud requires intent to obtain payment and the knowledge the actions are wrong.
  • Waste and abuse may involve obtaining improper payment or creating an unnecessary cost to government healthcare programs but do not require the same intent and knowledge
Organization Will Learn

Laws Combatting Fraud & Abuse.

Principal laws that are used to combat fraud & abuse against government healthcare programs:

  • False Claims Act – 31 USC § 3729 (FCA)
  • Anti- Kickback Statute – 42 USC §1320-7b(b)
  • Physician Self-Referral (“Stark”) Statute – §42 USC 1320-7b(b)
  • United States Criminal Code
  • Fraud Enforcement and Recovery Act of 2009 (“FERA”)

What Consequences Can Organizations Face for FCA, Stark Law or Anti-Kickback Violations?

There can be significant legal and financial consequences for violations of the laws that combat fraud against government healthcare programs.  These legal and financial penalties can include fines, imprisonment, and exclusion from participating in Federal government healthcare programs.

Conduct Training
Corporate Compliance

Compliance Programs Help with Legal Compliance.

Healthcare organizations must implement a compliance program, which is a set of internal policies and procedures that healthcare organizations put into place to help the organization comply with the law.  An effective compliance program has seven basic elements and should encompass not just employees but also personnel working as agents and contractors.  These written policies and procedures serve as the standard of conduct and must be updated as needed as the organization grows

HIPAA Certification Cost

Employee’s Obligation to Report Improper Activities to Employer.

All employees have an obligation to report improper activities to their employer.   In the event that employees discover a compliance error that could lead to a violation of the False Claims Act or other law that combat healthcare fraud, they should bring it to the attention of their immediate supervisor or compliance officer to investigate and rectify problems.

Protect Your Healthcare Organization with Medicare: Fraud & Abuse Training from Evolve e-Learning Solutions.

With Evolve e-Learning Solutions, your team receives high quality training to ensure their understanding of the laws that combat fraud and abuse against government healthcare programs such Medicare and Medicaid.  Our Medicare: Fraud & Abuse training course is crucial for your employees to understand the laws and work within the laws. We offer the proper tools and resources to provide your employees with the knowledge of the Medicare: Fraud & Abuse laws to maintain compliance.  This course can be bundled with other OSHA Safety for Healthcare, HIPAA, and HR/EEO courses to ensure a fully compliant workplace at discounted pricing.

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