decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Fraud and Abuse Control Program / Fraud and Abuse Control Program
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Article Overview
This article covers the federal Fraud and Abuse Control Program and its role in coordinating anti-fraud efforts across agencies and levels of government. It outlines the program’s major components, including enforcement coordination, Medicare program integrity functions, advisory opinions, fraud alerts, adverse action reporting, immunity protections, and beneficiary reporting incentives. The article is relevant to compliance, auditing, legal, and health care administration audiences tracking fraud and abuse oversight.
Why This Topic Matters
It helps readers understand the scope of federal fraud and abuse oversight and the related administrative structures that affect providers, payers, and compliance programs.
What You Will Learn
- How the fraud and abuse control framework coordinates enforcement activities
- What program integrity and oversight mechanisms are associated with the program
- Which related reporting, advisory, and alerting processes are discussed
- How the article connects fraud control with broader health care compliance efforts
Who Should Read This
- Health care compliance professionals
- Medical coders and coding auditors
- Revenue cycle and reimbursement staff
- Health care attorneys and legal/compliance teams
- Practice managers and administrators
Codes Discussed
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