PPT-Fraud, Waste and Abuse Prevention

EXCEL MSO seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of health plans federal and state authorities in their enforcement of prohibitions of fraudulent practices by providers members or other entities dealing with the provision of health care services. 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 . MPA Winter CE + Ski . January 12. th. , 2014. Jason Walker-Crawford, R.Ph. – PAAS National®, Inc.. Learning Objectives. Discuss the Medicare Part D requirements for Fraud, Waste & Abuse Compliance (FWAC).. Fraud, Waste and Abuse . Part I:. Overview. Objectives. . Convey GuildNet’s commitment to compliance.. Explain obligations of GuildNet’s. . first tier, downstream, and related entities to prevent, detect, and report fraud, waste and abuse.. 10 Things Contractors Need to Know. J. Lester Alexander, . III & Misty Decker. August 9, 2012. Top Ten Countdown. Things . Contractors Need to . Know about Fraud. Number 10.. . In connection with the American Recovery and Reinvestment Act of 2009 (“the Stimulus Act”), on May 20, 2009, President Obama signed the Fraud Enforcement and Recovery Act (“FERA”).. “Are the . fraudsters all . reading the same . fraud manual. ?”. Paul Crowder. Pre Sales Consulting. FICO. 08 May 2014. The International Healthcare Landscape. The Blessing & the Curse of Auto-Adjudication. Definition of an Individual Service Provider (ISP). An ISP assists Department of Rehabilitation (DOR) consumers to participate in vocational rehabilitation services and to prepare for, achieve, and maintain an employment outcome as outlined in their Individualized Plan for Employment. ISPs are independent . © IHCDA 2017. Purpose of investigating fraud, waste and abuse. Ensure. Benefits are allotted in correct amounts and only to those individuals who are eligible. Recover. tax dollars obtained by participants through fraudulent activities, unintentional participant error, administrative error or non-compliance. 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 . Definition of a Community Rehabilitation Program (CRP). A CRP is a program which directly provides or facilitates the provision of vocational rehabilitation services to individuals with disabilities, DOR consumers, to enable them to maximize opportunities for employment, including career advancement. . 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 . 2016 National Training Program. Session Objectives. This session should help you . Define fraud and abuse . Identify causes of improper payments. Discuss how CMS. fights fraud and abuse. Explain how you can fight fraud and abuse. TESTING WHITE PAPER JULY 2020 The Healthcare Fraud Prevention Partnership would like to thank participating Partners for their contributions This paper was prepared in collaboration with Dr R Sun Dr 2016 National Training Program. Session Objectives. This session should help you . Define fraud and abuse . Identify causes of improper payments. Discuss how CMS. fights fraud and abuse. Explain how you can fight fraud and abuse. 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:.