AHIP FWA 2022: Combating Medicare FWA

Combating Medicare Parts C and D Fraud, Waste, and Abuse 1. Combating Medicare Parts C and D Fraud, Waste, and Abuse 1.1 Combating Medicare Parts C and D Fraud, Waste, and Abuse

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1.2 Navigation Instructions

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1.3 Terms and Conditions

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1.4 Introduction

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1.5 Introduction

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1.6 Introduction

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1.7 Why Do I Need Training

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1.8 Training Requirements

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1.9 FWA Training Requirement Exception

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1.10 Navigating and Completing This Course

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1.11 Course Objectives

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1.12 Lesson 1: Introduction and Learning Objectives

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1.13 Fraud

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1.14 Waste and Abuse

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1.15 Examples of FWA

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1.16 Differences Among Fraud, Waste, and Abuse

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1.17 Understanding FWA

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1.18 Civil False Claims Act (FCA)

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1.19 Civil FCA (continued)

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1.20 Health Care Fraud Statute

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1.21 Criminal Health Care Fraud

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1.22 Anti-Kickback Statute

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1.23 Stark Statute (Physician Self-Referral Law)

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1.24 Civil Monetary Penalties (CMP) Law

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1.25 Exclusion

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1.26 Health Insurance Portability and Accountability Act (HIPAA)

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1.27 Lesson 1 Summary

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1.28 You completed Lesson 1: What Is FWA?

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1.29 Lesson 2: Introduction and Learning Objectives

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1.30 Where Do I Fit In?

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1.31 Where Do I Fit In? (continued)

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1.32 What Are Your Responsibilities?

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1.33 How Do You Prevent FWA?

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1.34 Stay Informed About Policies and Procedures

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1.35 Report FWA

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1.36 Reporting FWA Outside Your Organization

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1.37 Correction

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1.38 Indicators of Potential FWA

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1.39 Key Indicators: Potential Beneficiary Issues

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1.40 Key Indicators: Potential Provider Issues

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1.41 Key Indicators: Potential Pharmacy Issues

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1.42 Key Indicators: Potential Wholesaler Issues

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1.43 Key Indicators: Potential Manufacturer Issues

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1.44 Key Indicators: Potential Sponsor Issues

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1.45 Lesson 2 Summary

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1.46 Appendix A: Resources

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1.47 Appendix B: Job Aids

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1.48 Appendix B: Job Aids

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1.49 Job Aid C: Where to Report Fraud, Waste, and Abuse (FWA)

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1.50 You completed Lesson 2: Your Role in the Fight Against FWA

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