Module 1: Understanding Fraud, Waste, and Abuse
Defines fraud, waste, and abuse in healthcare and pharma, with clear examples drawn from billing, prescribing, documentation, and marketing.
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Healthcare & Pharma
30m
Fraud, Waste, and Abuse (FWA) Awareness
This course introduces healthcare and pharma staff to fraud, waste, and abuse (FWA) requirements tied to Medicare, Medicaid, and other government healthcare programs. It focuses on:
What this course covers
- Definitions of fraud, waste, and abuse in clinical, billing, and administrative contexts.
- How FWA impacts patients, payers, and organizations.
- Required FWA training obligations for organizations in government programs.
- How to recognize red flags and report concerns.
Modules
Module 2: Regulatory Framework and Government Programs
Explores major laws and programs governing FWA (Medicare, Medicaid, ACA anti-fraud provisions) and the role of agencies like OIG, CMS, DOJ.
Module 3: Common FWA Scenarios in Clinical and Billing Work
Provides concrete scenarios illustrating FWA in documentation, coding, billing, and ordering (e.g., upcoding, unbundling, medically unnecessary services).
Module 4: Kickbacks, Stark Law, and Anti-Corruption Risks
Explains Anti-Kickback Statute, Stark Law, and anti-corruption requirements, focusing on referral arrangements and financial relationships.
Module 5: Data Integrity, Documentation, and Audit Readiness
Focuses on data integrity, proper documentation, and audit readiness as FWA defenses.
Module 6: Recognizing Red Flags and Reporting FWA Concerns
Teaches staff how to spot FWA red flags (pressured coding changes, unusual ordering patterns, suspicious vendor requests) and outlines reporting processes.
Module 7: FWA in Pharma Sales, Marketing, and Medical Affairs
Addresses FWA risks unique to pharma: promotional practices, off-label marketing, HCP interactions, transparency and reporting obligations.
Module 8: Building a Culture of FWA Prevention
Synthesizes content into practical FWA prevention behaviors and team practices; highlights how FWA awareness supports compliance culture and integrity.
Course features
SCORM 1.2 or 2004
Audio Narration
Captions
Transcript
Knowledge Checks
Locked Navigation
Post-Assessment
Certificate
Frequently asked questions
Who should take Fraud, Waste, and Abuse (FWA) Awareness?
This course introduces healthcare and pharma staff to fraud, waste, and abuse (FWA) requirements tied to Medicare, Medicaid, and other government healthcare programs.
How long does the course take?
About 30 minutes, delivered across 8 modules with knowledge checks.
What does the course cover?
Definitions of fraud, waste, and abuse in clinical, billing, and administrative contexts; How FWA impacts patients, payers, and organizations; Required FWA training obligations for organizations in government programs; How to recognize red flags and report concerns.
Do learners receive a certificate?
Yes. The course issues a certificate on completion. It ships SCORM 1.2 or 2004 with audio narration, captions, transcript, and runs on the Provisant learning platform.
How much does it cost?
$5 per user per course per year. Annual billing saves 20%. Any course in the catalog can be added to a plan.