Healthcare Fraud and Abuse
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 much-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 35-minute course explains the basic rules regarding healthcare fraud and abuse in simple, understandable terms. It includes pop-quizzes, news clippings and a final quiz highlighting real-world compliance issues that employees should learn to recognize and deal with appropriately.
The topics covered in the course include —
- Fraud and abuse overview
- Possible penalties
- Fraud and abuse contexts
- Gifts and business courtesies
- Free goods and services
- Discounts and rebates
- Price reporting
- Administrative fees to GPOs
- Purchasing from customers
- Preceptorships
- Educational grants
- Support of scientific research
- Sponsorships of charitable activities
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Download Course Summary
