Compliance officers and other organizational leaders must be constantly vigilant of resource waste and the inappropriate and illegal use of funds from Medicare and other federal programs. Since hospitals and other health organizations depend on these funds, exclusion from these programs can devastate patient care and healthcare operations.
Compliance with Medicare and other programs requires relevant staff to take regular fraud, waste, and abuse (FWA) training. In addition to avoiding heavy fines and civil litigation, FWA compliance helps maintain the highest quality of patient care and preserves your organization’s financial stability. Here’s what you need to know about FWA training.
Importance of FWA Training
First and foremost, training in FWA compliance is the law. The Centers for Medicare and Medicaid Services, part of the U.S. Office of Inspector General, mandates yearly training in fraud, waste, and abuse detection and prevention for all hospitals and entities providing care, prescription medications, or other services to recipients of Medicare benefits.
Besides avoiding legal jeopardy, having staff take and complete FWA training has other benefits. Enabling employees to detect and prevent FWA instances will protect your integrity, save significant amounts of money, and avoid the waste of valuable resources. Also, the reputation you’ve worked so hard to maintain could be tarnished from just one case of non-compliance, making it difficult to regain the trust of patients, clients, and other stakeholders.
Components of Medicare FWA Training
An essential learning outcome of FWA training is differentiating fraud, waste, and abuse. Trainings teach about the definitions and FWA examples of each concept:
- Fraud is deliberately trying to get financial gain through providing false information or other deceptive activities. Examples include billing for services a patient didn’t receive or using a false billing code to charge more for a procedure.
- Waste includes intentional or unintentional actions that result in extra costs. Examples include ordering unneeded tests or accidentally double-billing for a procedure.
- Abuse refers to improper practices or use of services that result in excessive costs or financial loss. Examples of abuse are submitting a claim with false information or filing a claim for a service a patient didn’t receive.
Proper training includes understanding the federal and state laws regarding fraud, waste, and abuse in healthcare settings. Trainees also learn how fraud, waste, and abuse occur and the steps they must take to ensure FWA compliance. These steps include identifying FWA instances, reporting evidence of non-compliance, and identifying factors or conditions that could contribute to FWA.
Finally, FWA training should also cover the legal and financial ramifications of non-compliance, including fines, OIG exclusion from Medicare and other federal benefits, license revocation, and other consequences. FWA trainees should also understand the non-tangible repercussions of non-compliance, such as loss of trust and harm to the organization’s reputation.
Stay on Top of FWA Training With Compliance Software
It’s essential to provide your organization’s members with the FWA training they need. However, without software support from a trusted compliance service provider, knowing where to find the proper training and how to provide it can be challenging.
With software from Compliancy Group, Medicare FWA training is simpler and more efficient. You can easily assign staff training from a centralized dashboard, and they receive continuing credits. Software from Compliancy Group can also help you:
- Send out training renewal reminders
- Track employees’ training progress, exam scores, and completion status
- Tailor training to fit individuals’ roles, experience, learning styles, and job duties
- Store all training-related documents and make them available to employees
- Automate administrative functions
At Compliancy Group, we want to be your go-to resource for FWA compliance training. Contact us today to learn about software solutions we can customize to fit your needs.
