This continuing education class examines Medicare fraud and reviews the statutory and regulatory framework for targeting and reducing fraud. Prevention measures and their impact, including the most recent changes made under the Affordable Care Act ("ACA"), are reviewed. Civil monetary penalties, Medicare fraud reporting by whistleblowers, senior Medicare patrols, and Medicare fraud and abuse partnerships are evaluated. Case law is added for emphasis and understanding.

Class highlights include:

• False Claims Act ("FCA")


• Anti-Kickback Statute


• Criminal Health Care Fraud Statute


• Omnicare Fraud


• Medicare Fraud and Abuse Partnerships


• Health Care Fraud Prevention and Enforcement Action Team ("HEAT")


• ACA Fraud Prevention Provisions


• Federal Medicare Fraud Law


• Approved for 2 Hours of Elective Continuing Education