CMS Compliance: Medicare and Medicaid Fraud and Abuse Prevention

Program Description

This enduring activity will discuss the importance for physicians to be knowledgeable about the compliance requirements for participation in financial reimbursement from the Center for Medicare and Medicaid Services (CMS).  Physicians need to recognize the differences between fraud, waste, and abuse. Additionally, physicians should understand the causes of improper payments by CMS. Legal and administrative consequences of fraudulent activities will be discussed. Strategies to prevent fraud waste, and abuse will be presented.

Objectives

After completing this activity, learners will be able to:

  • Define the difference  between fraud and abuse
  • Identify two causes of improper payments
  • Discuss two ways CMS fights fraud and abuse 
  • Explain two ways you can fight fraud and abuse
  • Recognize two sources of additional information 

Disclosure

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

Faculty:

Richard Cahill, JD, Associate General Counsel, Vice President, The Doctors Company

Course Developer

Kathleen Stillwell, MPA/HSA, RN, CPHRM, Senior Patient Safety Risk Manager

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 1.75 AMA PRA Category 1 Credits™. Physicians should claim only those credit(s) commensurate with the extent of their participation in the activity.

The Doctors Company estimates one and three-quaters of an hour 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™.

Course ID#: TDE 16009.0
Issue Date for This Activity: 01-28-16
Expiration Date for This Activity: 01-28-19

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 1.75 continuing education credit(s). Dentists should claim only those credit(s) commensurate with the extent of their participation in the activity.

Course ID#: TDE 16009.0
Issue Date for This Activity: 01-28-16
Expiration Date for This Activity: 01-28-19

Disclaimer

The information and guidelines contained in this recorded 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 and should be used as a reference guide only.

Technical Requirements

This activity is best experienced using the most current browser (or one back) of Firefox, Chrome, Safari, Internet Explorer, or Microsoft Edge.  For all activities featuring audio you must have a sound card and speakers. 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.

Contact CME

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