PPT-MEDICARE COMPLIANCE:

A Practical Approach to MSAs Conditional Payments and Mandatory Reporting for WC and Liability Claims Operations September 19 2012 PRESENTERS Jon Gunter Executive VP MEDVAL Anne Hernandez. Developed by the Centers for Medicare & Medicaid Services . Issued. : February, 2013. This training module consists of two parts: (1) Medicare Parts C & D Fraud,. Waste, and Abuse (FWA) Training and (2) Medicare Parts C & D General . Theresa M. Shalaby, MSN, RN, CCRP. Manager, Clinical Trials Billing Compliance. Department of Finance. Vanderbilt University Medical Center. March . 22, 2013. Agenda. Overview of Vanderbilt University Medical Center (VUMC) Research Volume. Allegations. . Secret Shops. . Corrective Actions . Audits. An audit is an examination and evaluation of an organization to make sure that their records are accurate, and that the company and their contracted partners are adhering to the requirements of the contract. . Developed by the Centers for Medicare & Medicaid Services. This training module will assist Medicare Parts C and D plan Sponsors in satisfying the Compliance training requirements of the Compliance Program regulations at 42 C.F.R. §§ 422.503(b)(4)(vi) and 423.504(b)(4)(vi) and in Section 50.3 of the Compliance Program Guidelines found in Chapter 9 of the Medicare Prescription Drug Benefit Manual and Chapter 21 of the Medicare Managed Care Manual. Guidance for Meridian ACO Providers. Edition: Sep 2014. Learning Objectives. By the end of this course, you will be able to… . Understand federal and state fraud and abuse . laws.. Identify referral restrictions in Stark and similar . False Claims Act (42 U.S.C. 1320a-7b(b)). The False Claims Act is a federal law that prohibits any person from:. Knowingly presenting, or causing to be presented, to an officer or employee of the U.S. Government a false or fraudulent claim for payment or approval. . Developed by the Centers for Medicare & Medicaid Services. This training module will assist Medicare Parts C and D plan Sponsors in satisfying the Compliance training requirements of the Compliance Program regulations at 42 C.F.R. §§ 422.503(b)(4)(vi) and 423.504(b)(4)(vi) and in Section 50.3 of the Compliance Program Guidelines found in Chapter 9 of the Medicare Prescription Drug Benefit Manual and Chapter 21 of the Medicare Managed Care Manual. Physician Education. Every . year billions of dollars are improperly spent because of Fraud, Waste, and Abuse (FWA). It affects everyone – including you. This training helps you detect, correct, and prevent FWA. You are part of the solution. Compliance is everyone’s responsibility. As an individual who provides health or administrative services for Medicare enrollees, your every action potentially affects Medicare enrollees, the Medicare Program, or the Medicare . False Claims Act (42 U.S.C. 1320a-7b(b)). The False Claims Act is a federal law that prohibits any person from:. Knowingly presenting, or causing to be presented, to an officer or employee of the U.S. Government a false or fraudulent claim for payment or approval. . Fraud, Waste and Abuse. . (FWA). Training. 12/11/2013. FRAUD, WASTE AND ABUSE (FWA). EXECPTION-NOTICE. There is one exception to the FWA training and education requirement. Regulations effective June 7, 2010 implemented a “deeming” exception which exempts FDRs who are enrolled in Medicare Parts A or B from annual FWA training and education. Therefore, if an entity or an individual is enrolled in Medicare Parts A or B, the FWA training and education requirement has already been satisfied. If you are unsure if this “deeming” exception applies to you please contact an IEHP Compliance Manager at . Nina W. Tarnuzzer, MHA,CPA,CPC. Assistant Dean, Physician Billing Compliance. University of Florida, College of Medicine. Monday, November 7, 2011. Helpful Disclosure. Warning: These printed materials are not designed to include all points that will be presented in class or include information helpful to know for purposes of testing.. and Billing. , . and . More: . What . Every University Clinic Must . Know . and Implement. Paul . Pessis. , AuD. Tim . Nanof. , MSW. Disclosures:. Financial. Tim Nanof is employed full time by ASHA.. 2020. Please review the notes section of each slide for additional information and details.. Publicly-funded insurance program. Americans age 65 and over. Disabled Americans. A Medicare plan may include:. New Hire and Annual Employee Compliance Training. CTS Introduction. Coordinated Transportation Solutions, Inc.. CTS is a 501(c)(3) not-for-profit entity founded in Connecticut in 1997. We manage non-emergency transportation programs for government agencies, managed care organizations, school districts and businesses throughout the northeast and mid-Atlantic region. We do not have drivers and vehicles of our own that perform trips. Rather, we coordinate transportation using a network of credentialed and contracted, local transportation companies. .