Course Description

This course explains that Medicare is a national social insurance program that provides health benefits to millions of elderly and disabled Americans. It helps employees understand the costs and legal consequences of Medicare fraud, waste and abuse, as well as ways to prevent and combat it.

Learning Objectives

  • Defining Fraud, Waste, and Abuse
  • False Claims Act and Other Legislation
  • Following Policies and Procedures
  • Role of Beneficiaries, providers, pharmacies, manufacturers and wholesalers
  • Reporting problems

Course Syallabus

This module provides a brief introduction to the course content, including the thought behind the course’s usage of person-first language.

  • 1 Customizable Content Page
  • 1 Custom Video Page

This module lays the groundwork for the course by explaining the prevalence of Medicare fraud, waste, and abuse, and its cost on the the healthcare system. Through defining fraud, waste, and abuse and exploring relevant legislation and consequences of those actions, the learner is able to identify this behavior and contribute to preventing it in their workplaces.

  • 1 Customizable Content Page

This module emphasizes the importance of ensuring policies and procedures are followed, and that information gathered is accurate, timely, and regularly verified. The learner has the opportunity to apply these lessons to multiple interactive scenarios to identify multiple prevention strategies.

  • 2 Customizable Content Pages

This module explores the roles of beneficiaries, providers, pharmacies, manufacturers, and wholesalers in the claims process. By understanding these roles, the learner also explores the different motivations each of these players may have in contributing to Medicare fraud, waste, and abuse. The learner then applies this knowledge and practices identifying these warning signs through interactive scenarios.

  • 1 Customizable Content Page

This module reminds the learner of their duty to report suspicious behavior, as well as how they would be protected if they do choose to report.

  • 1 Customizable Content Page

This module provides a brief conclusion and summary of the course content.

This is the module you share your policies and additional resources.

  • 3 Custom Policies
  • 4 Customizable Content Pages
  • 1 Custom Video Page

Course Materials and Tools


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