Comprehensive Medicare Fraud & Abuse Training for Every Healthcare Role

Healthcare organizations face unprecedented scrutiny from federal enforcement agencies investigating Medicare fraud, waste, and abuse. From False Claims Act violations to Anti-Kickback Statute breaches and Stark Law infractions, a single compliance failure can result in millions in penalties, exclusion from federal programs, and criminal prosecution. Our comprehensive Medicare compliance training library addresses every critical requirement, ensuring your staff understands the laws, recognizes red flags, and protects your organization while meeting CMS compliance program expectations.

Medicare & Corporate Compliance Course Options

Whether you need foundational fraud and abuse awareness for new hires, specialized training for billing and coding staff, or comprehensive compliance programs for clinical and administrative teams, our courses deliver expert content that transforms complex federal regulations into practical, workplace-ready compliance skills. Explore our complete Medicare compliance training solutions below:

  • Medicare Fraud and Abuse

  • Anti-Bribery & FCPA Training Course

Course Features and Benefits

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Crystal-clear learning objectives set expectations up front and guide learners through the course—so they stay focused, understand what matters most, and finish with confidence.

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Engaging Videos and Professional Narration bring content to life with dynamic visuals and natural-sounding audio—making training more interactive, modern, and easier to absorb.

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Guided, step-by-step navigation keeps learners on track and ensures every required section is completed—supporting consistency and better compliance outcomes.

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Smart bookmarking automatically saves progress so learners can pick up exactly where they left off—no rewatching or hunting for their last page.

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Built-in practice that sticks with non-graded knowledge checks, scenarios, and exercises that reinforce key concepts and strengthen retention without pressure.

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Randomized final assessments pulled from a question bank to keep testing fair, consistent, and resistant to answer-sharing—while still measuring the right learning outcomes.

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Flexible LMS Integration Options SCORM-compliant courses work seamlessly with your existing LMS. Alternatively, use our enterprise-level Workplace LMS designed specifically for healthcare compliance training.

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Unlimited retakes to mastery so learners can reattempt the assessment until they meet the passing score—supporting learning, confidence, and completion without unnecessary roadblocks.

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 the problem.

Stay Informed: Medicare FWA & Corporate Compliance

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Medicare & Corporate Compliance Training FAQs

Any employee, contractor, or agent involved in billing, coding, claims submission, or patient care in organizations that receive Medicare/Medicaid payments should complete this training. This includes physicians, nurses, medical assistants, billing staff, coders, administrators, and business office personnel. The Deficit Reduction Act requires certain Medicaid-participating entities to educate employees about fraud and abuse laws.

Fraud requires intent to obtain payment and knowledge that actions are wrong—it’s deliberate deception. Abuse involves practices that may result in unnecessary costs but lack the intent to deceive (like consistently coding at higher levels without medical necessity). Waste refers to overutilization of services without intent or medical necessity. All can result in improper payments, but legal consequences vary based on intent and knowledge.

Our Medicare: Fraud & Abuse course covers the principal federal laws used to combat healthcare fraud: False Claims Act (FCA), Anti-Kickback Statute, Stark Law (Physician Self-Referral Law), Fraud Enforcement and Recovery Act (FERA), Patient Protection and Affordable Care Act provisions, and communication requirements from the Deficit Reduction Act (DRA). We explain each law’s requirements and real-world applications.

We recommend annual training as a best practice. Healthcare compliance programs should provide initial training upon hire and periodic refresher training thereafter. Annual training keeps employees current with evolving regulations, reinforces ethical decision-making, and demonstrates your organization’s commitment to compliance—important factors if violations are discovered.

Yes, they address different compliance requirements. Medicare fraud and abuse training covers billing practices, kickback prohibitions, and referral restrictions—protecting the financial integrity of federal healthcare programs. HIPAA training addresses patient privacy and data security—protecting health information. Most healthcare organizations need both. We offer bundled pricing for combined Medicare and HIPAA courses.

Yes. In fact, extending compliance training to business associates and contractors is recommended. Anyone handling billing, coding, or claims on your behalf should understand fraud and abuse laws. We offer the Medicare course both individually and bundled with HIPAA for Business Associates at a discounted rate.

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

Evolve e-Learning Solutions provides essential training on Medicare and Medicaid fraud and abuse laws, ensuring your healthcare team understands federal regulations and maintains compliance. Our Medicare: Fraud & Abuse course equips employees with practical knowledge to identify and prevent fraudulent activities while working within legal boundaries. Bundle this course with our OSHA Safety for Healthcare, HIPAA, and HR/EEO training for a complete compliance solution at discounted rates.

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