Combating Medicare Parts C and D Fraud, Waste, and …

Combating Medicare Parts C and D Fraud, Waste, and Abuse Web-Based Training Course January 2019

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Combating Medicare Parts C and D Fraud, Waste, and Abuse

TABLE OF CONTENTS ACRONYMS...................................................................................................................................................... 3 TITLE ................................................................................................................................................................. 4 INTRODUCTION .............................................................................................................................................. 5 LESSON 1: WHAT IS FWA?.......................................................................................................................... 12 LESSON 2: YOUR ROLE IN THE FIGHT AGAINST FWA........................................................................ 32 POST-ASSESSMENT...................................................................................................................................... 55 APPENDIX A: RESOURCES ......................................................................................................................... 66 APPENDIX B: JOB AIDS ............................................................................................................................... 68

Medicare Learning Network?

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Combating Medicare Parts C and D Fraud, Waste, and Abuse

ACRONYMS

The following acronyms are used throughout the course.

ACRONYM CFR CMS EPLS FCA FDRs FWA HIPAA LEIE MA MAC MLN NPI OIG PBM WBT

DEFINITION Code of Federal Regulations Centers for Medicare & Medicaid Services Excluded Parties List System False Claims Act First-tier, Downstream, and Related Entities Fraud, Waste, and Abuse Health Insurance Portability and Accountability Act List of Excluded Individuals and Entities Medicare Advantage Medicare Administrative Contractor Medicare Learning Network? National Provider Identifier Office of Inspector General Pharmacy Benefits Manager Web-Based Training

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Combating Medicare Parts C and D Fraud, Waste, and Abuse

TITLE

TITLE PAGE

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Combating Medicare Parts C and D Fraud, Waste, and Abuse

INTRODUCTION

INTRODUCTION PAGE 1 The Combating Medicare Parts C and D Fraud, Waste, and Abuse course is brought to you by the Medicare Learning Network?

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