
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.
Contact Us for a Free Course Trial!
View Medicare: Fraud and Anti-Bribery Courses Descriptions below
Our compliance courses include audio, video, knowledge checks and a final assessment. Students receive a certificate of completion when they complete and pass the course. Deliver the courses on Evolve’s WorkPlace LMS or your own LMS.

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

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.


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

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.