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Healthcare Fraud and Abuse PDF Print
Training ProviderLearn Skills

Assessment

Quizzes & Final Exam
Location learnskills.org Qualification Certificate of Completion
Method Asynchronous Self-paced EligibilityOpen
Cost50 EUREnrol Now  

Learn Skills Online Course

According to the Government Accounting Office, healthcare fraud and abuse account for three to ten percent of all healthcare costs — well over $100 billion annually. Whatever the cost, fraud and abuse waste badly needed resources and seriously undermine our healthcare system.

The healthcare industry is subject to many different laws that concern fraud — including the False Claims Act, the Stark Law, the Anti-Kickback Statute, HIPAA and the Prescription Drug Marketing Act. On top of this legislative infrastructure, government agencies and trade organizations have created a patchwork of guidelines and codes. Together, these laws, guidelines and codes present a significant compliance challenge.

Course Summary
This Course is intended to help healthcare professionals and employees navigate the regulatory maze and raise awareness about fraud and abuse so that misconduct can be detected and prevented.

The topics covered include —
  • Fraud and abuse overview
  • Possible penalties
  • Company policies
  • Gifts, business courtesies, meals and receptions
  • Free goods and services
  • Discounts and rebates
  • Price reporting
  • Administrative fees to group purchasing organizations (GPOs)
  • Purchasing Goods and Services
  • Preceptorships
  • Educational Grants
  • Support of Scientific Research
  • General Sponsorship and Charitable Contributions
  • Prescription Drug Marketing Act
  • Code of the Pharmaceutical Research and Manufacturers of America
  • Guidelines of the Department of Health and Human Services, Office of Inspector General (OIG Guidelines)
  • Guidelines of Accreditation Council for Continuing Medical Education Standards (ACCME Guidelines)