Healthcare Fraud

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Healthcare Fraud

Learning Objectives

To analyze the types of fraud that should be on the audit’s radar.
To discuss how to evaluate fraud risk for their organization based on the trends discussed.
To discuss controls that should be implemented right away.
To inspect how as a citizen healthcare fraud affects you personally.

Course Description

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:

Traditional trends in healthcare fraud.
Latest trends in healthcare fraud.
Prevention of fraud in healthcare today

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.

Webinar Qualifies For

2 CPE Credit of Auditing for Certified Public Accountants (CPA-US)
2 General Credit of Auditing for Accountant/Bookkeeper/Tax Professionals
2 CPE Credit of Fraud risks for Certified Internal Auditors (CIA)
2 CPE Credit of Fraud Auditing and Forensic Accounting for Certified Fraud Examiner (CFE)
2 CPE Credit of Auditing for Certified Management Accountants (CMA)
2 CPE Credit of Auditing for Certification in Risk Management Assurance (CRMA)
2 CPD Credit of Fraud prevention, detection and response for Certified Financial Forensics (CFF)
2 CPE Credit of Auditing for Certified Government Financial Manager (CGFM)
2 CPE Credit of Auditing for Internal Audit Practitioner (IAP)
2 CPE Credit of Auditing for Master Analyst In Financial Forensics (MAFF)
2 CPE Credit of Fraud Auditing and Forensic Accounting for Certified Internal Controls Auditor (CICA)
2 CPE Credit of Internal Audit Planning for Qualification in Internal Audit Leadership (QIAL)
2 CPE Credit of Auditing for Iowa Licensed Public Accountant (IA-LPA)
2 CPE Credit of Auditing for Maine Licensed Public Accountant (ME-LPA)
2 CPE Credit of Auditing for Delaware Licensed Public Accountant (DE-LPA)
2 CPE Credit of Fraud Auditing and Forensic Accounting for Certified Controls Specialist (CCS)

About Instructor

Denise Cicchella

Founder & CEO, Auspicium

Denise Cicchella is a recognized expert in construction audit, protecting owners from the overpayment of construction costs due to error, negligence or fraud.

Dense is a Certified Internal Auditor, Certified Fraud Examiner, Certified Construction Auditor, Project Management Professional and Fellow of the Life Management Institute. She holds an MBA in International Business from Fairleigh Dickinson University and a BBA in Accounting from Loyola University. She is the Founding President of the New York/New Jersey Chapter of the National Association of Construction Auditors. She has audited and led audit teams for small construction project as well as multi billion dollar projects.

She is an experienced trainer and can often be seen teaching domestically and internationally.

Additional Information

Duration

2 Hours

Course Level

Basic

Instructional Method

Group Internet Based

Pre-requisites

None

Advance Preparation

None

FAQ’s

Click Here to View

NASBA APPROVED

MY-CPE LLC, 1600 Highway 6 south, suite 250, sugar land, TX, 77478

MY-CPE LLC (Sponsor Id#: 143597) is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.NASBARegistry.org.

Ratings and Review

4.4

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Very Good

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Terrible

Lynnae Langmann, CPA (US)

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

Wendy Ramdeen Nancoo, CIA

This was everything that I wanted from the course. The practical examples was very interesting and useful.

Janet Stelly, CPA (US)

Lots of great examples within the healthcare industry.

Jean Hess, CFE, CPA/CITP, CPA (US)

Good topics and coverage of Healthcare Fraud material.

Kathy Kovach, CPA (US)

Good examples from every possible place or person

2 Credits

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Subject Area

Auditing

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Healthcare Fraud

Course Details

Learning Objectives

Course Description

Qualifies for

Webinar Qualifies For

Presenter Details

About Instructor

Denise Cicchella

Other Details

Additional Information

2 Hours

Basic

Group Internet Based

None

None

FAQ’s

NASBA APPROVED

Ratings and Review

4.4

Lynnae Langmann, CPA (US)

Wendy Ramdeen Nancoo, CIA

Janet Stelly, CPA (US)

Jean Hess, CFE, CPA/CITP, CPA (US)

Kathy Kovach, CPA (US)

Subject Area

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