Full Length
Healthcare Fraud Prevention: Avoiding Improper Referrals, Kickbacks and Claims
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At a glance
Course Details
All Learners
Key concepts covered in this course:
- Definitions of fraud, waste and abuse – and what they can look like
- Correction and corrective planning that may be involved if fraud, waste or abuse is detected
- Key indicators of fraud, waste and abuse
- A brief overview of the Physician Self-Referral Law, or Stark Law
- Key terms under the law, including designated health service, immediate family member, financial relationship and exception
- Penalties for improper referrals
- Brief overviews of key laws, like the Anti-Kickback Statute and the Stark Law
- Examples of safe harbors
- Penalties for involvement with kickbacks
- A brief overview of the False Claims Act
- Common types of false claims
- Best practices for accurate certifications
- The importance of making reports of suspected misconduct
- Understanding and following policies and procedures
- Ensuring complete and accurate medical and billing records
- Documenting financial relationships
- Seeking clarification as necessary
- Reporting suspected misconduct
- Review of the critical role employees play in speaking up about illegal or unethical behavior
- An opportunity to review key policies and certify