Healthcare Compliance and Risk: Healthcare Fraud Laws, Regulations, and Enforcement

$15.00

Format: On demand

Duration: 200 Mins

Instructors: Coral MED

Learning Credits: 0.2 CEU

*This course was updated on Jan 01, 1970.

Description

This unit introduces learners to the legal and regulatory frameworks governing healthcare fraud prevention. It provides an in-depth understanding of key U.S. laws and compliance standards such as the False Claims Act (FCA), Anti-Kickback Statute (AKS), Stark Law, and Health Care Fraud Statute. Learners explore how these laws work together to prevent unethical practices, protect government healthcare programs, and ensure transparency in billing, contracting, and patient care. The course also covers the roles of enforcement agencies like the Office of Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS), and the Department of Justice (DOJ). Through real-world case examples, students will examine legal consequences of non-compliance and learn strategies to maintain adherence to regulatory requirements.

Identify the key federal fraud prevention laws and regulations that govern healthcare organizations (e.g., False Claims Act, Anti-Kickback Statute, Stark Law). Discuss the implications of major fraud prevention regulations for the operations and strategic decision-making of healthcare organizations. Analyze the roles and responsibilities of compliance officers and internal legal counsel in enforcing fraud prevention laws within healthcare organizations. Identify the roles of key federal agencies (e.g., Office of Inspector General (OIG), Department of Health and Human Services (HHS), Department of Justice (DOJ)) in investigating and enforcing fraud prevention regulations. Analyze the ethical considerations and potential consequences of non-compliance with fraud prevention laws for healthcare organizations, professionals, and patient trust. Evaluate the effectiveness of current fraud prevention regulations in curbing fraudulent activities and promoting ethical conduct across the healthcare sector. Formulate comprehensive strategies for healthcare organizations to proactively ensure adherence to fraud prevention laws and mitigate risks of non-compliance.

By the end of this unit, learners will be able to: Understand the foundational laws and policies governing healthcare fraud prevention. Interpret the implications of major fraud-related statutes on organizational operations. Identify enforcement authorities and their responsibilities in compliance oversight. Apply legal knowledge to real-world healthcare scenarios to ensure lawful conduct. Contribute to policy development and compliance initiatives that align with regulatory expectations.

Completion of Session 3, Preventing Healthcare Fraud or prior knowledge of healthcare compliance frameworks and ethical standards.

Follow Coral Plus LMS policies: participation, integrity, respectful conduct, HIPAA/privacy adherence, timely completion of assessments. 1. Participants should register in advance to receive access details. 2. Access links and passwords, if applicable, should be provided securely to registered participants. 3. Participants are encouraged to join the webinar a few minutes early to resolve any technical issues 4. Participants are responsible for ensuring a stable internet connection, compatible devices (computer, tablet, or smartphone), and recommended browsers. 5. A microphone and webcam may be required for interactive sessions. Please test your audio and video settings in advance. 6. The webinar may be recorded for educational purposes. 7. Recorded sessions may be shared with registered participants after the webinar. 8. Please be mindful not to share personal or confidential information during the webinar. 9. A detailed agenda will be provided, and each session will adhere to the schedule to cover all planned topics. 10. Time will be allocated for Q&A sessions and discussions. 11. A helpdesk or contact information for technical support will be provided during the webinar. 12. Common technical issues will be addressed at the beginning of the session. 13. Relevant resources, such as presentation slides or additional reading materials, will be shared after the webinar. Proprietary Interest Policy: It is the policy of Coral MED that if instructors have a vested interest in any product, instrument, device, or materials that may be used in the learning event, they must disclose this interest. Further, if the instructors receive any share of the royalties or profits from the product promotion or endorsement, the interest must be disclosed to the learner. If there are any breaches of this policy, please contact Coral MED at +1 (808) 913-7979 OR send an email to compliance@coralmed-inc.com Anti Discrimination Policy: Coral MED is committed to providing work and learning environments free of sexual or any form of unlawful harassment or discrimination. Harassment or unlawful discrimination against individuals on the basis of race, religion, creed, color, national origin, sex, sexual orientation, gender identity, age, ancestry, physical or mental disability, medical condition including medical characteristics, marital status or any other classification protected by local, state or federal laws is illegal and prohibited by Coral MED policy. If there are any breaches of this policy, please contact Coral MED at +1 (808) 913-7979 or send an email to compliance@coralmed-inc.com 6) Privacy & Data Protection Policy Coral MED values the privacy, security, and integrity of your learner records. Your information is managed in accordance with Policy CM012 – Learner Records Privacy and Data Security Policy, which complies with applicable data protection laws and accreditation standards.How to Request the Release or Correction of Your Records If you wish to obtain, release, or correct your learner records, please follow these steps: 1. Submit a written or electronic request to: elearn@coralmed-inc.com ↗ . 2. Include your full name, learner ID, and specific request type (e.g., transcript, name correction, verification letter). 3. Requests are processed within 10 business days of verification. 4. You will receive an email confirmation once your request has been fulfilled. Notification of Record Availability Upon completion of a learning event, Coral MED notifies learners via email when official records (e.g., transcripts, certificates, or CEUs) are issued or available for download within the LMS. You may review the full policy at any time by visiting:. View Policy ↗

Healthcare compliance and legal professionals ensuring adherence to fraud and abuse laws. Auditors and investigators interpreting and applying legal standards in practice. Healthcare administrators and executives responsible for organizational compliance strategy. Students and researchers studying health law, policy, or compliance management. Consultants and policy developers guiding organizations through regulatory audits and enforcement actions.