Healthcare Fraud 2 Credits
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Healthcare fraud is not a victimless crime. It affects everyone and causes tens of billions of dollars in losses each year. It can raise health insurance premiums, expose you to unnecessary medical procedures, and increase taxes. Healthcare fraud can be committed by medical providers, patients, and others who intentionally deceive the healthcare system to receive unlawful benefits or payments.
How does healthcare fraud work?
Corporate fraud by healthcare providers accounts for the lion’s share of the fraud. Providers were complicit in 62% of cases, and beneficiaries were complicit in 14% of cases. Many fraud schemes mimic legitimate transactions with complicit doctors and other medical professionals. Additionally, the sheer volume of healthcare claims makes fraud detection a challenge.
Whether it is an abuse of Medicaid payments, illegal prescriptions, or unbundling, medical fraud continues to grow. This is dangerous, as not only does it affect the country financially, it can be dangerous. While the challenges of detecting healthcare fraud are numerous, understanding common healthcare fraud schemes is the first step.
This CPE Fraud webinar by Denise Cicchella will look at traditional and upcoming trends in healthcare fraud as learned from the DOJ and Health Watch.
This CPE Auditing Course covers the following major topics:
When a health care fraud is perpetrated, the health care provider passes the costs along to its customers. Because of the pervasiveness of healthcare fraud, statistics now show that 10 cents of every dollar spent on healthcare goes toward paying for fraudulent healthcare claims.
| License details | Credits | Status |
|---|---|---|
| Auditing for Certified Public Accountants (CPA-US) | 2 CPE | Approved |
| Fraud risks for Certified Internal Auditors (CIA) | 2 CPE | Eligible |
| Auditing for Certified Management Accountants (CMA) | 2 CPE | Eligible |
| Auditing for Delaware Licensed Public Accountant (DE-LPA) | 2 CPE | Eligible |
| Auditing for Certified Government Financial Manager (CGFM) | 2 CPE | Eligible |
| Auditing for Internal Audit Practitioner (IAP) | 2 CPE | Eligible |
| Health Care Fraud for Certified Fraud Examiner (CFE) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Internal Controls Auditor (CICA) | 2 CPE | Eligible |
| Business Fraud and Deterrence for Master Analyst In Financial Forensics (MAFF) | 2 CPE | Eligible |
| Auditing for Certification in Risk Management Assurance (CRMA) | 2 CPE | Eligible |
| Auditing for Qualification in Internal Audit Leadership (QIAL) | 2 CPE | Eligible |
| Auditing for Iowa Licensed Public Accountant (IA-LPA) | 2 CPE | Eligible |
| Auditing for Maine Licensed Public Accountant (ME-LPA) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Controls Specialist (CCS) | 2 CPE | Eligible |
| Fraud prevention, detection and response for Certified Financial Forensics (CFF) | 2 CPD | Eligible |
| License details | Credits | Status |
|---|---|---|
| Auditing for Certified Public Accountants (CPA-US) | 2 CPE | Approved |
| Fraud risks for Certified Internal Auditors (CIA) | 2 CPE | Eligible |
| Auditing for Certified Management Accountants (CMA) | 2 CPE | Eligible |
| Auditing for Delaware Licensed Public Accountant (DE-LPA) | 2 CPE | Eligible |
| Auditing for Certified Government Financial Manager (CGFM) | 2 CPE | Eligible |
| Auditing for Internal Audit Practitioner (IAP) | 2 CPE | Eligible |
| Health Care Fraud for Certified Fraud Examiner (CFE) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Internal Controls Auditor (CICA) | 2 CPE | Eligible |
| Business Fraud and Deterrence for Master Analyst In Financial Forensics (MAFF) | 2 CPE | Eligible |
| Auditing for Certification in Risk Management Assurance (CRMA) | 2 CPE | Eligible |
| Auditing for Qualification in Internal Audit Leadership (QIAL) | 2 CPE | Eligible |
| Auditing for Iowa Licensed Public Accountant (IA-LPA) | 2 CPE | Eligible |
| Auditing for Maine Licensed Public Accountant (ME-LPA) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Controls Specialist (CCS) | 2 CPE | Eligible |
| Fraud prevention, detection and response for Certified Financial Forensics (CFF) | 2 CPD | Eligible |
| License details | Credits | Status |
|---|---|---|
| Auditing for Certified Public Accountants (CPA-US) | 2 CPE | Approved |
| Fraud risks for Certified Internal Auditors (CIA) | 2 CPE | Eligible |
| Auditing for Certified Management Accountants (CMA) | 2 CPE | Eligible |
| Auditing for Delaware Licensed Public Accountant (DE-LPA) | 2 CPE | Eligible |
| Auditing for Certified Government Financial Manager (CGFM) | 2 CPE | Eligible |
| Auditing for Internal Audit Practitioner (IAP) | 2 CPE | Eligible |
| Health Care Fraud for Certified Fraud Examiner (CFE) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Internal Controls Auditor (CICA) | 2 CPE | Eligible |
| Business Fraud and Deterrence for Master Analyst In Financial Forensics (MAFF) | 2 CPE | Eligible |
| Auditing for Certification in Risk Management Assurance (CRMA) | 2 CPE | Eligible |
| Auditing for Qualification in Internal Audit Leadership (QIAL) | 2 CPE | Eligible |
| Auditing for Iowa Licensed Public Accountant (IA-LPA) | 2 CPE | Eligible |
| Auditing for Maine Licensed Public Accountant (ME-LPA) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Controls Specialist (CCS) | 2 CPE | Eligible |
| Fraud prevention, detection and response for Certified Financial Forensics (CFF) | 2 CPD | Eligible |
| License details | Credits | Status |
|---|---|---|
| Auditing for Certified Public Accountants (CPA-US) | 2 CPE | Approved |
| Fraud risks for Certified Internal Auditors (CIA) | 2 CPE | Eligible |
| Auditing for Certified Management Accountants (CMA) | 2 CPE | Eligible |
| Auditing for Delaware Licensed Public Accountant (DE-LPA) | 2 CPE | Eligible |
| Auditing for Certified Government Financial Manager (CGFM) | 2 CPE | Eligible |
| Auditing for Internal Audit Practitioner (IAP) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Fraud Examiner (CFE) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Internal Controls Auditor (CICA) | 2 CPE | Eligible |
| Auditing for Master Analyst In Financial Forensics (MAFF) | 2 CPE | Eligible |
| Auditing for Certification in Risk Management Assurance (CRMA) | 2 CPE | Eligible |
| Internal Audit Planning for Qualification in Internal Audit Leadership (QIAL) | 2 CPE | Eligible |
| Auditing for Iowa Licensed Public Accountant (IA-LPA) | 2 CPE | Eligible |
| Auditing for Maine Licensed Public Accountant (ME-LPA) | 2 CPE | Eligible |
| Fraud Auditing and Forensic Accounting for Certified Controls Specialist (CCS) | 2 CPE | Eligible |
| Fraud prevention, detection and response for Certified Financial Forensics (CFF) | 2 CPD | Eligible |
Credits
Course Level
Instructional Method
Pre-requisites
Advance Preparation
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Denise Cicchella is a seasoned expert in audit and compliance, boasting over two decades of experience in the industry. As a Certified Internal Auditor (CIA) and Certified Fraud Examiner (CFE), she has a distinguished track record of enhancing organizational integrity and efficiency through meticulous financial oversight and strategic risk management. Denise’s expertise spans various sectors, including healthcare, manufacturing, and finance, where she has consistently demonstrated her ability to uncover and mitigate fraud, optimize internal controls, and drive compliance initiatives.
Denise is a published author and has written four books on internal audit and project management. They are:
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To maintain compliance, you must adhere to the guidelines set by NASBA and other regulatory bodies, which include attending the full duration of the webinar, participating in interactive elements, and completing any post-webinar evaluations or assessments.
After successfully attending a live webinar and fulfilling all participation requirements, you can access and download your completion certificates from your account dashboard on our platform. These certificates are recognized by NASBA, IRS, CFP Board, HRCI, SHRM, Payroll Org, FP Canada, and 25+ other regulatory bodies for compliance and reporting purposes.
We issue instant credit certificates, ensuring they are valid for presentation to governing bodies. Typically, we report IRS, CTEC, CFP, IDFP, IWI, VBOA Ethics credits within 7 days – the fastest in the industry.
LL
Very important topic. Good, informative presentation which was well researched & articulated. All of the handouts very helpful & interesting. Emphasis on each of us doing our part to review our medical bills & EOBs was appreciated. Thank you.
WRN
This was everything that I wanted from the course. The practical examples was very interesting and useful.
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