Learning
Credentialing
Compliance
Medicare Partes C y D Combate de Fraude, Derroche y Abuso
Esta capacitación ayuda a los empleados de los patrocinadores de planes de Medicare Partes C y D, a los miembros del órgano de gobierno y a sus entidades de primer nivel, y hacia abajo y relacionadas (FDRs) a cumplir con los requisitos anuales de capacitación en Fraude, Derroche y Abuso (FWA) establecidos en las regulaciones y directrices sub-regulatorias en:
42 CFR 422.503(b)(4)(vi)(C)
42 CFR 423.504(b)(4)(vi)(C)
Programas de Medicare y Medicaid; Cambios de Política y Técnicos para el Año Contractual 2022 en el Programa de Medicare Advantage, el Programa de Beneficios de Medicamentos Recetados de Medicare, el Programa de Medicaid, el Programa de Planes de Costo de Medicare, y los Programas de Cuidado Integral para Ancianos
Sección 50.3.2 de las Directrices del Programa de Cumplimiento (Manual de Beneficios de Medicamentos Recetados de Medicare, Capítulo 9 y Manual de Atención Administrada de Medicare, Capítulo 21)
Los patrocinadores y sus FDRs deben proporcionar capacitación adicional especializada o de actualización sobre cuestiones que representen riesgos de FWA, basadas en la función laboral del empleado o el entorno empresarial.
Medicare Partes C y D Combate de Fraude, Derroche y Abuso
Esta capacitación ayuda a los empleados de los patrocinadores de planes de Medicare Partes C y D, a los miembros del órgano de gobierno y a sus entidades de primer nivel, y hacia abajo y relacionadas (FDRs) a cumplir con los requisitos anuales de capacitación en Fraude, Derroche y Abuso (FWA) establecidos en las regulaciones y directrices sub-regulatorias en:
42 CFR 422.503(b)(4)(vi)(C)
42 CFR 423.504(b)(4)(vi)(C)
Programas de Medicare y Medicaid; Cambios de Política y Técnicos para el Año Contractual 2022 en el Programa de Medicare Advantage, el Programa de Beneficios de Medicamentos Recetados de Medicare, el Programa de Medicaid, el Programa de Planes de Costo de Medicare, y los Programas de Cuidado Integral para Ancianos
Sección 50.3.2 de las Directrices del Programa de Cumplimiento (Manual de Beneficios de Medicamentos Recetados de Medicare, Capítulo 9 y Manual de Atención Administrada de Medicare, Capítulo 21)
Los patrocinadores y sus FDRs deben proporcionar capacitación adicional especializada o de actualización sobre cuestiones que representen riesgos de FWA, basadas en la función laboral del empleado o el entorno empresarial.
Prevencion de fraude, derroche y abuso contra Medicare y Medicaid
Este curso ofrece una visión general de cómo las actividades fraudulentas afectan negativamente a los programas de Medicare y Medicaid. Los participantes explorarán esquemas comunes de fraude y aprenderán sobre las estrategias y asociaciones utilizadas por los Centros de Servicios de Medicare y Medicaid (CMS) para combatir estos problemas. Diseñado para formadores y proveedores de información familiarizados con el programa de Medicare, este curso también ofrece valiosas ideas sobre cómo detectar, prevenir y abordar el fraude y el abuso para garantizar la integridad de los servicios de salud.
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Prevencion de fraude, derroche y abuso contra Medicare y Medicaid
Este curso ofrece una visión general de cómo las actividades fraudulentas afectan negativamente a los programas de Medicare y Medicaid. Los participantes explorarán esquemas comunes de fraude y aprenderán sobre las estrategias y asociaciones utilizadas por los Centros de Servicios de Medicare y Medicaid (CMS) para combatir estos problemas. Diseñado para formadores y proveedores de información familiarizados con el programa de Medicare, este curso también ofrece valiosas ideas sobre cómo detectar, prevenir y abordar el fraude y el abuso para garantizar la integridad de los servicios de salud.
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Medicare Parts C and D FWA and Compliance Training 1 hour
This course helps pharmacies avoid government investigations and fines by providing the learner with an understanding of Medicaid and Medicare fraud, waste, and abuse regulations, as well as corresponding company-specific policies and procedures. CMS standards and recommendations are rolled into a single course so employees can avoid multiple, time-consuming, and costly training.
Medicare Parts C and D FWA and Compliance Training 1 hour
This course helps pharmacies avoid government investigations and fines by providing the learner with an understanding of Medicaid and Medicare fraud, waste, and abuse regulations, as well as corresponding company-specific policies and procedures. CMS standards and recommendations are rolled into a single course so employees can avoid multiple, time-consuming, and costly training.
2024 Medicare Part C and Part D Reporting Requirements and Data Validation
The 2024 Medicare Part C & Part D Reporting Requirements & Data Validation (DV) Web-Based Training (WBT) Course, provided by the Medicare Learning Network® (MLN), is designed to educate Sponsoring Organizations (SOs) and Data Validation Contractors (DVCs) on the CMS Data Validation program. This course covers critical CMS requirements, standards, and resources for accurately reporting and validating Medicare Part C and Part D data. Through this training, participants will understand the purpose of the DV program, the necessary steps for successful completion, and the resources available for navigating the DV process. This course is required before the DV process begins on April 1, 2024, to ensure compliance and readiness for the upcoming cycle.
2024 Medicare Part C and Part D Reporting Requirements and Data Validation
The 2024 Medicare Part C & Part D Reporting Requirements & Data Validation (DV) Web-Based Training (WBT) Course, provided by the Medicare Learning Network® (MLN), is designed to educate Sponsoring Organizations (SOs) and Data Validation Contractors (DVCs) on the CMS Data Validation program. This course covers critical CMS requirements, standards, and resources for accurately reporting and validating Medicare Part C and Part D data. Through this training, participants will understand the purpose of the DV program, the necessary steps for successful completion, and the resources available for navigating the DV process. This course is required before the DV process begins on April 1, 2024, to ensure compliance and readiness for the upcoming cycle.
CMS – Combating Medicare Parts C and D Fraud, Waste, and Abuse
In 2022, the Centers for Medicare and Medicaid issued an updated web-based training for Preventing Fraud, Waste, and Abuse Parts C and D. This course links to the CMS public website and must be completed on the CMS platform. This training assists Medicare Parts C and D plan Sponsors’ employees, governing body members, and their first-tier, downstream, and related entities (FDRs) to satisfy their annual fraud, waste, and abuse (FWA) training requirements. FWA training must occur within 90 days of initial hire and at least annually thereafter. Topics covered include FWA overview, Civil False Claims Act (FCA), Health Care Fraud Statute, criminal fraud, Anti-Kickback Statute, Civil Monetary Penalties Law, Health Insurance Portability, and reporting FWA.
CMS – Combating Medicare Parts C and D Fraud, Waste, and Abuse
In 2022, the Centers for Medicare and Medicaid issued an updated web-based training for Preventing Fraud, Waste, and Abuse Parts C and D. This course links to the CMS public website and must be completed on the CMS platform. This training assists Medicare Parts C and D plan Sponsors’ employees, governing body members, and their first-tier, downstream, and related entities (FDRs) to satisfy their annual fraud, waste, and abuse (FWA) training requirements. FWA training must occur within 90 days of initial hire and at least annually thereafter. Topics covered include FWA overview, Civil False Claims Act (FCA), Health Care Fraud Statute, criminal fraud, Anti-Kickback Statute, Civil Monetary Penalties Law, Health Insurance Portability, and reporting FWA.
Medicare Parts C and D General Compliance Training
This course introduces Medicare’s different components, focusing on Medicare Parts C and D compliance, including fraud prevention, waste, and abuse (FWA). Participants will explore the roles and responsibilities of providers under the program, CMS compliance requirements, and strategies for ensuring adherence to regulations. The course also covers the seven core elements of an effective compliance program and the consequences of non-compliance.
Medicare Parts C and D General Compliance Training
This course introduces Medicare’s different components, focusing on Medicare Parts C and D compliance, including fraud prevention, waste, and abuse (FWA). Participants will explore the roles and responsibilities of providers under the program, CMS compliance requirements, and strategies for ensuring adherence to regulations. The course also covers the seven core elements of an effective compliance program and the consequences of non-compliance.
Medicare for People with End-Stage Renal Disease (ESRD)
This course was developed and approved by the Centers for Medicare and Medicaid Services (CMS), the Federal agency that administers Medicare, Medicaid, and the Childrens Health Insurance Program (CHIP) and the Health Insurance Marketplace. This course provides basic information about End-Stage Renal Disease (ESRD) and Medicare eligibility, Medicare enrollment based on ESRD, what Medicare covers, coverage options for people with ESRD, and additional sources to learn more.
Medicare for People with End-Stage Renal Disease (ESRD)
This course was developed and approved by the Centers for Medicare and Medicaid Services (CMS), the Federal agency that administers Medicare, Medicaid, and the Childrens Health Insurance Program (CHIP) and the Health Insurance Marketplace. This course provides basic information about End-Stage Renal Disease (ESRD) and Medicare eligibility, Medicare enrollment based on ESRD, what Medicare covers, coverage options for people with ESRD, and additional sources to learn more.
Code of Conduct for Medicare
The course provides the conceptual framework of important considerations for establishing and maintaining a Code of Conduct and how it compliments and reinforces an organizations Compliance Program. The essential elements of a Compliance Program such as written policies and procedures, compliance programs, compliance committees, establishing a code of conduct, audits, consistent discipline, and corrective action. Real-life scenarios will be presented to help you understand how the Code of Conduct is used in the workplace.
Code of Conduct for Medicare
The course provides the conceptual framework of important considerations for establishing and maintaining a Code of Conduct and how it compliments and reinforces an organizations Compliance Program. The essential elements of a Compliance Program such as written policies and procedures, compliance programs, compliance committees, establishing a code of conduct, audits, consistent discipline, and corrective action. Real-life scenarios will be presented to help you understand how the Code of Conduct is used in the workplace.
The Medicare Access and Chip Reauthorization Act of 2015
On April 27, 2016, the Department of Health and Human Services issued a Notice of Proposed Rulemaking to implement key provisions of the Medicare Access and CHIP Reauthorization Act of 2015. This course will cover the quality payment program of this act and examine what a quality payment program is, how to submit comments on proposed rules, merit-based incentive payment systems, and incentives in participating in advanced alternative payments.
The Medicare Access and Chip Reauthorization Act of 2015
On April 27, 2016, the Department of Health and Human Services issued a Notice of Proposed Rulemaking to implement key provisions of the Medicare Access and CHIP Reauthorization Act of 2015. This course will cover the quality payment program of this act and examine what a quality payment program is, how to submit comments on proposed rules, merit-based incentive payment systems, and incentives in participating in advanced alternative payments.