Preventing Fraud, Waste, and Abuse (FWA) in Healthcare

Overview

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Preventing fraud, waste, and abuse (FWA) is critical to protecting patients, safeguarding healthcare resources, and maintaining trust across the healthcare system. Fraud, waste, and abuse drive up costs, undermine care quality, and expose organizations and individuals to serious legal and financial consequences. This course provides a clear, practical foundation for understanding FWA and its impact on healthcare operations. You will learn how to distinguish between fraud, waste, and abuse, recognize common schemes and red flags, and understand the core requirements of key federal laws, including the False Claims Act, Anti-Kickback Statute, and Stark Law. The course explains how these laws apply to real-world healthcare scenarios and what compliance looks like in daily practice. Through real enforcement examples and interactive activities, you’ll develop practical skills to identify potential FWA risks, apply prevention strategies, and follow proper reporting procedures. You’ll also explore the essential elements of an effective compliance program and understand your role in supporting ethical, lawful healthcare practices. Designed for healthcare professionals, payers, and administrators, this course equips you with the knowledge and confidence to help prevent FWA and promote a culture of accountability and compliance.

Syllabus

Module 1: FWA Definitions, Laws, and Consequences

This module establishes the foundational knowledge learners need to understand and comply with federal healthcare fraud laws. It defines the distinctions between fraud, waste, and abuse, then provides an in-depth examination of the False Claims Act, Anti-Kickback Statute, and Stark Law—including their intent requirements, common violations, and applicable safe harbors or exceptions. Enforcement case studies ground these concepts in real-world consequences, and practice activities reinforce accurate classification of healthcare scenarios.

Module 2: Final Assessment

This module measures learner mastery of the full course through scenario-based assessment. Using realistic healthcare situations, learners demonstrate their ability to classify FWA, apply the False Claims Act, Anti-Kickback Statute, and Stark Law, identify red flags, select appropriate reporting channels, and apply compliance program principles. A minimum passing score confirms readiness to meet annual FWA training requirements.