CMS Fraud, Waste and Abuse in Health Care Only $24.95
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Accepted by Reptrax, VendorMate and Symplr (VCS) Credentialing Services
Faculty: Donna L Atherton RN, MSN, NP and Diane Leis MA

Release Date: May 11, 2018
Valid Through: May 11, 2020. This course will be updated or expired on this date
Successful Completion: Complete entire module, complete the exam with a passing score of 80% or better, and complete the evaluation form
Estimated Time to Complete Activity: 60 minutes
CEUs: See Continuing Education section
Media: Internet. Available 24/7 365 Online. See requirements below


Broaden your knowledge of fraud, waste and, abuse in the health care environment.

learning objectives

  • Identify the mandatory laws governing Medicare fraud and abuse.
  • Describe your part in preventing Medicare fraud, waste, and abuse.
  • Summarize what you can do to detect, correct, and prevent fraud, waste, and abuse.



CMS and the Social Security Act govern the Medicare Program, including Parts C and D

The Social Security Act (Act of August 14, 1935)
Provided for the general welfare by establishing a system of Federal old-age benefits, and by enabling the States to make more adequate provision for aged persons, blind persons, dependent and crippled children, maternal and child welfare, public health, and the administration of their unemployment compensation laws; to establish a Social Security Board; to raise revenue; and for other purposes.

The CMS Affordable Care Act (ACA) of 2010 expands the Health Insurance Portability and Accountability Act (HIPAA) of 1996 with new and expanded mandates:

Health care providers and suppliers implement compliance programs as a condition of participating in Federal health care programs (Medicare, Medicaid, Children’s Health Insurance Program).
New operating rules for each HIPAA transaction
Creation of a unique, standard Health Plan Identifier (HPID)
New standards for electronic funds transfer and electronic health care claims attachments.
Health plans must certify compliance with standards.
Penalties for health plans that fail to comply or certify compliance.

Medicare sponsors must have an effective compliance program and training for employees, managers, and directors, as well as their first tier, downstream, and related entities, which includes measures to prevent, detect and correct Medicare non-compliance, and measures to prevent, detect and correct fraud, waste, and abuse.
•Part C and Part D programs provide health and prescription drug benefits for eligible individuals 65 years and older, and eligible individuals with disabilities. CMS contracts with private companies, referred to as “sponsors”, to provide health and prescription drug benefits to beneficiaries’ enrolled in Medicare Advantage- Prescription Drug (MA-PD), MA-only and standalone PDPs.
•CMS is responsible for administering and conducting oversight of the Medicare programs. 


  • • Instant Certificate Of Completion Printing Upon Successful Completion Of Online CMS Fraud, Waste and Abuse Training Course
  • • Free Retakes on Exam Until You Pass
  • • Instant Access: 100% Online - Access 24/7 from Anywhere
  • • 30 Day Money Back Guarantee: No Recurring Fees

Continuing Education

Disclosures of Conflicts of Interest

HIPAA Exams, Inc. requires that the faculty participating in any activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been resolved prior to this activity. HIPAA Exams, Inc. also requires participating faculty to disclose when unapproved/unlabeled uses of a product are discussed in a activity.

Disclosure of Unlabeled Use

This activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products.


The content for this activity was developed independently of the commercial support. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with the ANCC Accreditation Criteria, Policies, and Standards for Commercial Support. Recommendations involving clinical medicine in a continuing medical education activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

Operating Systems Requirements

  • Windows: XP or higher
  • Mac OS X: 10.5 or higher
  • Android:* Lollipop and Marshmallow
  • iOS:* 9 or higher

Minimum System Requirement

  • Disk Space: 600 MB of free hard drive space


  • Windows: Internet Explorer 8 or higher**, Firefox latest (32-bit), Chrome latest
  • Mac OS X: Safari 7 and above
  • Pop-up blockers should be turned off

Internet Connection Speed

  • Windows: Intel Pentium® processor (1GHz or faster), At least 1 GB RAM


  • Graphics card: 800x600 pixel resolution or greater (1024x768 pixels recommended).

Only $24.95


Bundle Price Per Person
1-14 $24.95
15-49 $19.99
50-99 $17.99
100 + Call for $

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