On-Site Training Topic Details

Healthcare Fraud

The healthcare industry is faced with many unique regulations, systems, procedures and records. For anti-fraud professionals working in this industry or advising clients who operate healthcare practices, we have designed this course for you. Here you will get the specialized training you need to keep up with the latest fraud schemes and related laws affecting this highly complex industry.

Who Should Attend: 

Internal auditors for hospitals and medical offices
Accountants, auditors, attorneys and investigators who service healthcare industry clients
Government investigators charged with identifying fraud or noncompliance with government funded healthcare facilities and programs

What You Will Learn: 

Federal, state, criminal and civil regulations imposed upon the healthcare industry including HIPAA, anti-kickback rules, and other legalities having a correlation between the industry and fraud.
Understanding provider reimbursements including Medicare, Medicaid, HMO's and more.
Fraud issues specific to various sectors within the industry including hospitals, home healthcare, long-term care, pharmaceutical manufacturers and others.
Investigation techniques appropriately designed for the healthcare environment to address interview techniques, sampling, data analysis, medical records analysis and forensic evidence collection.
Industry compliance programs, federal sentencing guidelines, and Sarbanes-Oxley's impact on compliance programs in healthcare facilities.

CPE Credits: 16

Course Level: Basic

Prerequisite: None.


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