The Security Scrutinizer with Howard Anderson

Preventing Fraud: Training Is Key

Too Many Med Students Never Get Compliance Education
Preventing Fraud: Training Is Key

A recent fraud law compliance training survey by the Department of Health and Human Services Office of the Inspector General found that only 44 percent of 131 medical schools surveyed offer instruction on Medicare and Medicaid fraud and abuse laws.

Compliance training is somewhat more pervasive at hospitals and other institutions offering residency and fellowship programs. Sixty-eight percent of 387 institutions offering these programs reported providing fraud and abuse compliance instruction.

It's time for medical schools, as well as residency and fellowship programs, to make education about fraud and abuse law compliance a priority. 

But there's some good news as well. Based on its findings, the OIG will create educational materials on fraud and abuse law compliance to "provide medical schools and hospitals with a consistent starting point on which to build their training programs," a new OIG report states. In refining the educational effort, the OIG will seek feedback from the educational institutions on "emerging compliance challenges that physicians hospitals and other providers face."

No federal law requires medical schools and hospitals offering physician training to provide instruction on compliance with federal fraud and abuse laws, the report notes. But if the training doesn't improve as a part of the OIG's efforts, perhaps Congress will take action.

After all, how can new physicians be expected to comply with fraud and abuse laws if they know nothing about them?

And cracking down on fraud could go a long way toward cutting the nation's health care bill.

As I noted in a recent blog, a fraud case involving only one physician resulted in $13 million in fraudulent billing of Medicare and more than 30 other insurers.

That fraud case involved obvious criminal intent to rip off the insurers. But federal fraud and abuse rules, including the anti-kickback statute and the physician self-referral statute (better known as the Stark law), contain complex provisions banning more subtle forms of fraud, such as steering patients to facilities in which you have an ownership stake.

It's time for medical schools, as well as residency and fellowship programs, to make education about fraud and abuse law compliance a priority. And while they're at it, they should provide more thorough training on the use of electronic health records and how to keep them private and secure.

About the Author

Howard Anderson

Howard Anderson

Former News Editor, ISMG

Anderson was news editor of Information Security Media Group and founding editor of HealthcareInfoSecurity and DataBreachToday. He has more than 40 years of journalism experience, with a focus on healthcare information technology issues. Before launching HealthcareInfoSecurity, he served as founding editor of Health Data Management magazine, where he worked for 17 years, and he served in leadership roles at several other healthcare magazines and newspapers.

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