Medicare Fraud and Abuse: Prevention, Detection, and Reporting

Program Description

This activity is designed for all Medicare providers. Learn about fraud and abuse definitions; laws used to fight fraud and abuse; government partnerships engaged in fighting fraud and abuse; and where to report suspected fraud and abuse. 

Although there is no precise measure of health care fraud, and the majority of health care providers are honest and well-intentioned, a minority of providers who abuse the system can cost taxpayers billions of dollars. Such losses can result in substandard medical care and services for beneficiaries who depend on equipment, medications, or exams for a better quality of life. The Federal government aggressively cracks down on fraud and abuse, but it needs your help. All health care professionals must do their part to prevent fraud and abuse.

This course consists of five lessons:

Lesson 1: Medicare Fraud and Abuse explains the basics of fraud and abuse

Lesson 2: Medicare Fraud and Abuse Laws and Penalties provides information about the laws and sanctions used to fight fraud and abuse

Lesson 3: Prevention of Medicare Fraud and Abuse describes the methods used to prevent Medicare fraud and abuse

Lesson 4: Detection of Medicare Fraud and Abuse provides an overview of entities charged with detecting Medicare fraud and abuse

Lesson 5: Reporting Medicare Fraud and Abuse contains information on how to report suspected Medicare fraud and abuse, how to self-disclose violations, and the rewards available for reporting fraud and abuse

Objectives

After completing this activity, learners will be able to:

  • Identify the definitions of Medicare fraud and abuse.
  • Identify provisions and penalties associated with Medicare fraud and abuse.
  • Recognize methods to prevent Medicare fraud and abuse.
  • Recognize entities that detect Medicare fraud and abuse.
  • Recognize how to report Medicare fraud and abuse.

Disclosure

No individual in a position to control or influence the content of this activity has reported relevant financial relationships with commercial interests. No commercial support was provided for this activity. 

Course Developers

CMS MLN

CMS Privacy Policy

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For questions regarding the content of this activity click HERE to contact the Medicare Learning Network®

Continuing Education Credit

The Doctors Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical educational activities for physicians.

The Doctors Company designates this enduring material activity for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Doctors Company estimates one and a quarter hours for completion of this course. A passing score of 80 percent or greater is required to successfully complete the activity and earn AMA PRA Category 1 Credit™.

The Doctors Company is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.

ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at ADA.org/CERP.

The Doctors Company designates this enduring material activity for 2.25 continuing education credit. Dentists should claim only the credit commensurate with the extent of their participation in the activity.

Course ID#: TDE 18033.0
Issue Date for This Activity: 10/29/2018
Expiration Date for This Activity: 10/29/2021

Disclaimer

The information and guidelines contained in this enduring material activity are generalized and may not apply to all practice situations. The faculty recommends that legal advice be obtained from a qualified attorney for specific application to your practice. The information is intended for educational purposes only.

Complies with State Requirements

Please click HERE to see the Federation of State Medical Boards overview of Continuing Medical Education requirements by State.

Technical Requirements

This activity is best experienced using the most current browser (or one back) of Firefox, Chrome, Safari, Internet Explorer, or Microsoft Edge.  To view graphic images and references that appear in separate "pop-up" windows, you must have JavaScript and session cookies enabled on your computer.  Adobe Acrobat Reader may be required for certain activities.

Resources

Click HERE to download a PDF with resources related to this program.

Contact Us

If you have questions, contact educationsupport@thedoctors.com or call (800) 421-2368, extension 1243.