Fraud Against Government Health Care Programs (Online Self-Study)

Fraud Against Government

CPE Credit: 4
Course Level: Overview
Prerequisite: None

Description:  

 

Health care is one of the largest and arguably the most complex of all industries in the U.S. The system consists of numerous types of organizations, a vast body of regulations, a diversified consumer base, competing special interests and a massive amount of funds changing hands on a daily basis. Many of these traits that make the health care industry unique are the same ones that make it susceptible to fraud.

In this course, you will learn how to combat the costly health care fraud epidemic. You will examine common fraud schemes against government programs, legal initiatives associated with health care fraud, data analytics techniques to identify suspicious activity and the unique aspects of health care fraud investigations.
 

You will learn how to:
 

Identify specific types of health care fraud, including billing, coding, marketing, insurer and beneficiary schemes

Navigate the third-party payment system and key players of government health care

Associate legal violations with fraudulent acts

Prepare for the ongoing changes resulting from the Patient Protection and Affordable Care Act

Apply data analysis techniques to health care program schemes

Conduct an effective health care fraud examination

 

Preview Course 

 

Field of study: Specialized knowledge and applications

Last updated: March 2013

 

ACFE Ordering and Return Policy 

 

Please note: To be eligible for CPE credit, you must complete the final exam within one year of purchase date. You may only claim CPE credit for a course once. 

Table of Contents: 

 

Lesson 1: Structure of the U.S. Public Health Care System

Lesson 2: Key Programs in Public Health Care

Lesson 3: Health Care Fraud Defined

Lesson 4: The Effects of Fraud on Public Health Care

Lesson 5: False Billing Schemes

Lesson 6: Coding Schemes

Lesson 7: Corruption Schemes

Lesson 8: Fraudulent Advertising and Licensing

Lesson 9: Beneficiary Fraud Schemes

Lesson 10: Schemes by Other Third Parties

Lesson 11: Laws Prohibiting Fraud Against Public Health Care Programs

Lesson 12: Current and Expected Changes from the Affordable Care Act

Lesson 13: The Role of Data Analysis in Prevention and Detection

Lesson 14: The Examination Strategy for Health Care Fraud

 

ACFE online self-study courses feature:

24/7 access to courses through your Internet browser
Save time and quickly earn CPE credits with instant access, grading and printable certificate
The flexibility to start or stop a course and pick-up right where you left off
No additional shipping fees 
 

Learn more about accessing your online self-study course.

Learn more about online self-study courses and their features.

 

System requirements:

 

Internet access: High-speed connection recommended

Free Adobe Flash Player 

Speakers required for video sound

Online Self-Study Troubleshooting Guide:

Problem: When I attempt to access my courses from “My Online Learning,” the course never launches, or I receive an error message saying my pop-up blocker needs to be turned off.

Solution: Your web browser must be configured to allow pop-ups in order to access ACFE Self-Study courses. Your browser may prompt you to allow pop-ups, or you may have to allow them manually. You may either allow them for all sites, or allow them just for the current site.

For information on how to manage your pop-up blocker settings in a specific browser, click the link below that corresponds to the browser you are using:

  Internet Explorer
  Google Chrome
  Firefox

Also note that many toolbars, such as the Google Toolbar and Yahoo! include pop-up blockers as well. If you have one or more toolbars installed on your browser with built-in pop-up blockers, you must configure them to allow pop-ups.

Problem: When I click on a course from “My Online Learning,” I am presented with a login page, but my ACFE.com username and password won’t allow me to log in.

Solution: You do not have to log in a second time to access your online self-study. You most likely reached the login page because you clicked the link labeled “Click Here” as shown below:

 

  Online SS Image Absorb Error 

 

Do not click that link; instead, allow your browser to automatically open the eLearning window on its own, which should happen after a few seconds. This will log you in automatically so that you can access your online courses.

 

Problem: I receive the following error when I try to load a different lesson with a course:

 

  SS Online API Error 

 

Solution: This occurs in Internet Explorer when trying to load a different lesson without closing the current lesson. This error can be avoided two different ways:

 

Always close the current lesson before going to another one. Always click the Close Window button (usually the red “X” in the upper right corner) of the current lesson before clicking on another lesson.


Use a different browser. This error seems to only occur in Internet Explorer, so using Mozilla Firefox or Google Chrome should resolve the issue (see below for links to download either of these browsers).

 
Other Troubleshooting Tips: If you encounter other errors, such as courses freezing or crashing, we recommend taking the following action:
 

Try a different browser. ACFE online self-study courses are designed to run on all modern web browsers, but if you encounter a problem that is not solved using one of the suggestions above, you can try using a different web browser to see if it eliminates the problem. We have most frequently seen where using Mozilla Firefox or Google Chrome has resolved an issue that was seen in Internet Explorer.

 
Mozilla Firefox can be downloaded here
Google Chrome can be downloaded here 

 

Make sure you are running the latest version of Flash. Go to Adobe.com to see what version of Flash you are running, and then compare that to the table on that page to see what the latest version is for your operating system/browser combination. If you are not running the newest version, you should upgrade and see if that resolves the problem.