Fraud and Abuse Investigations 101

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This self-paced online course covers what you need to know before a health care fraud and abuse investigation.

In each module, you’ll click through concise explanations and examples and watch microvideos in which experienced attorneys share their personal insights. Self-assessments are included throughout the course to keep you engaged and on track. Click here for a preview.

Each module will take between 10 and 30 minutes to complete. Topics include:

    • Introduction to Fraud and Abuse in Health Care
    • Overview of Enforcement Agencies
    • The Statutory Framework for Fraud and Abuse Investigations
    • Requests for Information, Investigatory Demands, and Subpoenas
    • Responding to Requests for Information
    • Handling On-Site Demands for Records and Access
    • Retaining an Attorney During the Investigation
    • Internal Audits and Investigations
    • Statistical Sampling
    • Responding to Payer Audits and Initiating Appeals
    • How to Tell the Government It Gave You Too Much Money
    • A Deeper Dive into Administrative Sanctions
    • Prejudgment Remedies and Criminal Forfeiture
    • Criminal and Civil Settlements

Click here for a more detailed syllabus.

Based on a book by Paul W. Shaw and Robert A. Griffith. With commentary from Ritu Kaur Cooper, Greg Demske, Tizgel K. S. High, Amanda Hill, Tony Maida, Crane Pomerantz, and Melissa A. Wong

Group licenses available. For information, email agreene@americanhealthlaw.org.

AHLA is seeking CLE and CCB approval. The maximum number of credits available is approximately 4.75. Please note that the actual number of credits may vary from state to state. 

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