Fraud Abuse & Waste Training

Learn the rules that regulate the distribution of prescription drug benefits.

Fraud, waste and abuse are terms used by the medical administrative field to describe unlawful or negligent spending practices by medical professionals, administrative employees and patients. Training programs provide employees with an understanding of the Medicare system and the rules and regulations surrounding the administration of the program.

Programs

Individuals involved with the delivery of prescription drug benefits, offered by Medicare, must obtain fraud, waste and abuse training as part of a compliance program. Employees must attend a training session upon initial hiring, as well as subsequent refresher training every year. Training can take place through live discussions, seminars, online tutorials and videotaped presentations.

Courses

Course options for introductory and renewing participants include Coding for the Health Care Fraud Investigator, Preventing Fraud, Waste & Abuse, Investigating Hospital & Facility Fraud and the Painful Price of Health Care Fraud. Individuals that participate in a fraud, abuse and waste training program receive continuing professional education credits.

Curriculum

Topics discussed during the program include a review of compliance policies and procedures, business ethics, Medicare program requirements, confidentiality of personal health information, conflicts of interest, data and technology in investigations and gifts and gratuities for government employees.

References

• Centers for Medicare and Medicaid Services: Prescription Drug Benefit Manual
• National Health Care Anti-Fraud Association: Online Learning