Medicare Fraud Training

Oversight

Each organization that provides medical goods and services under Medicare Advantage or Prescription Drug Plan must supply annual training to their employees about fraud. This type of training program shows in part how an organization complies with regulations 42 C.F.R. ž422.503 (b)(4)(vi) and 42 C.F.R. ž423.504 (b)(4)(vi) published by the Centers for Medicare & Medicaid Services (CMS).

This training educates providers about the definition of fraud. Examples of Medicare fraud include billing Medicare programs for incorrect services or for services that were never rendered. A person who commits fraud either obtains or attempts to obtain payment from a Medicare insurer for services.

Medical providers, such as facilities at the University of Texas Houston, inform workers by posting documents on their website from the Medical Learning Network. This website includes informational documents that organizations can disseminate as appropriate. With access to the newest documents, employees can read and understand new federal regulations regarding Medicare service delivery and billing.

CMS has branded its nationally approved educational providers to train Medicare fee-for-service providers under the Medical Learning Network. This website maintains a catalog of training products and programs. On this website, you can download educational web guides and podcasts in addition to accessing web-based training modules and informational articles. Providers can purchase products and download free documents instead of paying for custom in-house training.

Medicare fraud training also helps medicare providers and their staff to educate seniors and other Medicare recipients, such as disabled persons, when they come into the office or call on the phone. Your staff may hear stories from Medicare recipients who have been victimized by fraud over the phone, at their own front door or through the mail. Training enables your staff to give patients the information they need to report Medicare fraud.