Course Overview

Fraud, waste, and abuse (FWA) cost healthcare systems billions each year, impacting patient care and trust. The Healthcare Fraud, Waste and Abuse Investigations Training for Medicare course provides a comprehensive understanding of how to identify, investigate, and prevent fraudulent activities in Medicare and Medicaid programs.

This course explores legal frameworks, investigative techniques, enforcement actions, and compliance systems designed to protect program integrity. Learners will gain practical insights into detecting FWA, reporting violations, and implementing preventive strategies that ensure accountability within healthcare organisations.

By completion, you’ll have the analytical and procedural skills to detect irregularities, support investigations, and strengthen Medicare fraud prevention measures in compliance with federal and state regulations.

Learning Outcomes

• Understand the definitions and scope of healthcare fraud, waste, and abuse (FWA).
• Identify relevant laws, regulations, and enforcement agencies governing FWA.
• Recognise the mechanisms of FWA detection within Medicare and Medicaid.
• Apply investigative techniques for identifying and documenting fraudulent activity.
• Understand enforcement procedures, penalties, and legal remedies.
• Develop risk management strategies to prevent and mitigate FWA.
• Collaborate effectively with agencies and reporting bodies.
• Learn from real-world case studies and best practices in FWA investigations.

Why Choose Us?

Here’s Why This Course is the Best Choice for You:

• Lifetime Access: Revisit course materials anytime, forever.
• Expert Support: Get help from our dedicated tutor team, available Monday to Friday.
• Learn at Your Pace: Study from home, on your schedule, with no pressure.
• Cutting-Edge Content: Access video modules taught by industry-leading instructors.
• 24/7 Assistance: Reach out via email or live chat whenever you need help.
• Multi-Device Access: Learn on your computer, tablet, or smartphone—anywhere, anytime.
• Career-Boosting Certification: Earn a certificate to showcase your skills and enhance your resume.

Assessment

Test Your Knowledge and Earn Your Certification

The course includes interactive quizzes to help you track your progress and reinforce your learning. These quizzes are designed to:

• Identify areas where you need more practice.
• Build confidence in your understanding of the material.
• Prepare you for real-world challenges.

Upon successfully completing the final quiz, you’ll receive a certificate of achievement—a valuable addition to your resume and LinkedIn profile.

Description

Module 01: Introduction to Healthcare Fraud, Waste, and Abuse (FWA)
Understand what constitutes fraud, waste, and abuse in healthcare. Learn how unethical billing, coding, and claims practices impact Medicare systems.

Module 02: Legal and Regulatory Frameworks Governing FWA
Explore key legislation such as the False Claims Act, Anti-Kickback Statute, and Stark Law, and understand how they regulate healthcare practices.

Module 03: Medicare/Medicaid Program Integrity and FWA Detection
Learn how Medicare and Medicaid monitor program integrity through data analysis, audits, and compliance systems to detect anomalies and prevent misuse.

Module 04: Investigative Techniques in Healthcare FWA Cases
Gain practical knowledge of fraud detection methods, including data mining, documentation review, whistleblower analysis, and interview techniques.

Module 05: Enforcement Actions and Remedies for FWA
Examine enforcement processes, penalties, and corrective actions led by agencies such as the Office of Inspector General (OIG) and the Department of Justice (DOJ).

Module 06: Risk Management and Prevention Strategies for FWA
Develop preventive strategies that promote ethical conduct, internal controls, and compliance training to reduce fraud risks within healthcare organisations.

Module 07: Collaboration and Reporting Mechanisms
Learn how agencies and organisations collaborate on FWA cases, including reporting through CMS systems and coordination with law enforcement partners.

Module 08: Case Studies and Best Practices in FWA Investigations
Review real-world case studies that highlight common fraud patterns, successful investigations, and best practices for compliance and prevention.

Career Path

Healthcare Compliance Officer: £40,000 – £65,000
Medicare Fraud Investigator: £38,000 – £60,000
Risk & Compliance Manager: £45,000 – £70,000
Healthcare Auditor: £35,000 – £55,000