Healthcare Fraud - HLTH-X827
Course Description
New for Fall - Learn About Fraud, Waste, and Abuse Across Healthcare Systems
This course provides an in-depth examination of healthcare fraud, waste, and abuse (FWA) across commercial, Medicare, and Medi-Cal programs. Students learn how fraudulent schemes are developed, detected, investigated, and prosecuted within the U.S. healthcare system. Emphasis is placed on regulatory frameworks, payer requirements, SIU operations, data analytics, medical billing and coding integrity, and interagency collaboration.
Learner Outcomes
- Identify and analyze common healthcare fraud, waste, and abuse (FWA) schemes across multiple provider types and benefit programs.
- Apply federal and state laws - including the False Claims Act, Anti-Kickback Statute, Stark Law, and Medicare/Medi-Cal program integrity requirements - to real investigative scenarios.
- Conduct compliant fraud investigations, including evidence collection, medical record review, claims analysis, interviewing, and case documentation.
Course Details
Number of Units: 2.0 graduate level extension credit(s) in semester hours
Who Should Attend: This continuing education course is intended for SIU Investigators, Healthcare Compliance Officers, Medical Billing & Coding Professionals, Program Integrity Staff, Law Enforcement, Regulatory Agency Personnel, and Healthcare Attorneys.
Online Self-Paced courses are a perfect blend of accessibility, convenience and flexibility for you to control your learning pace. You will use course textbooks, manuals, assignments and exams to learn and earn credit. Depending on the course, you may also use streaming audio and video, CD-ROM, and download embedded materials through the Internet. Communication with your instructor will take place through your course site online. Your instructor will provide feedback via written responses on your assignments and exams. Grades are based on completed projects, assignments and exams. You can register at any time and you will have six months from the time of registration to complete your course.