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.

Credit Information:

CLE: The maximum number of credits available for ON DEMAND is approximately 4.75 for a 50-minute state. Please note that the availability of credits may vary from state to state.  This self-study course will be available for purchase for approximately one year after the recording date, but state rules on duration of eligibility for CLE-credits differ, so please check with your state before purchasing self-study offerings. 

CPE: CPE credits are not available for on-demand. 

CCB: The Compliance Certification Board (CCB)® has approved this event for up to 4.75 NON-LIVE CCB CEUs based on a 50-minute hour. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this event content or of the event sponsor. 

For additional information, please visit the AHLA Continuing Education page. 

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