Medicare & Medicaid Fraud, Waste & Abuse for Direct Care Providers

Learning Objectives

Upon completion of this 1-hour training, participants will be able to:

1. Define fraud, waste, and abuse and distinguish between these concepts in healthcare settings.
2. Recognize common examples of Medicare and Medicaid fraud, waste, and abuse that may occur in home care and other direct-care environments.
3. Identify warning signs and potentially improper practices, including falsification of records, billing for services not provided, unnecessary services, and misuse of beneficiary information.
4. Explain the direct-care provider's responsibility for maintaining accurate, truthful, and complete documentation of services provided.
5. Describe appropriate steps for reporting suspected fraud, waste, abuse, or other compliance concerns through an employer's established reporting procedures or other appropriate channels.
6. Recognize the importance of confidentiality, ethical conduct, and non-retaliation protections when reporting compliance concerns.
7. Apply basic fraud, waste, and abuse prevention principles to common situations encountered by HHAs and other direct-care personnel.

Training Purpose: This course provides general compliance education for HHAs and other direct-care providers. It is not represented by VIDA Training Center as a Florida-mandated annual HHA in-service.