Healthcare Fraud, Waste, and Abuse

Every year the Federal Government reports billions of dollars of Medicare program losses and costs due to fraud, waste, and abuse (FWA). All individuals or employees of healthcare providers, service and administrative support suppliers, and health plan sponsors, directly or indirectly contracted with the Medicare program, must do their part to prevent, detect, and correct fraud and abuse to Medicare beneficiaries, the Medicare Program, or the Medicare Trust Fund.

Learning objectives:

• Define healthcare fraud, waste, and abuse. Recognize examples of FWA. Explain the major healthcare fraud, waste, and abuse laws and regulations, corresponding penalties associated with violations and examples of violations. Define the role of healthcare entities, employees and contractor in FWA prevention, detection, and reporting