Healthcare Fraud

Course Description

Health care 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. Health care fraud can be committed by medical providers, patients, and others who intentionally deceive the health care 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.

In this Online CPE fraud prevention webinar Denise Cicchella will look at traditional and upcoming trends in healthcare fraud as learned from DOJ and Health watch.

This Online CPE/CPD 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 health care fraud, statistics now show that 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims.

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 trends discussed.
• To discuss controls that should be implemented right away.
• To inspect how as a citizen healthcare fraud affects you personally.

Recommended For

• The Online continuing education webinar is recommended for CPAs, CMAs, CIAs, QIALs, IAPs, CFFs, CFFs, MAFFs, CITPs, CRMA, Fraud Analyst, Fraud Examiner, Fraud Investigator, Fraud Professionals, Risk Managers, Young CPA, and other professionals interested in learning more about Healthcare Frauds and ways to prevent them.
  

Who Should Attend?

Webinar Qualifies For

• 2 CPE Credit 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 Health Care Fraud for Certified Fraud Examiner (CFE)
• 2 CPE Credit for Certified Government Financial Manager (CGFM)
• 2 CPE Credit of Fraud risks for Certified Internal Auditors (CIA)
• 2 CPE Credit of Auditing for Certified Public Accountants (CPA-US)
• 2 CPE Credit for Internal Audit Practitioner (IAP)
• 2 CPE Credit for Qualification in Internal Audit Leadership (QIAL)
• 2 CPE Credit for Master Analyst In Financial Forensics (MAFF)
• 2 CE Credit for Certified Fiduciary & Investment Risk Specialist (CFIRS)
• 2 CE Credit for Certified Wealth Strategist (CWS)
• 2 General Credit for Accountant/Bookeeper
• 2 CPE Credit of Fraud for Certified Valuation Analyst (CVA)
• 2 CRE Credit for Certified Treasury Professional (CTP)
• 2 CPE Credit of Fraud for Certified Business Appraiser/Master Certified Business Appraiser (CBA/MCBA)

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