Most physicians strive to work ethically, render quality medical care to their patients, and submit proper claims for payment. However, there have been instances when physicians either willingly or unknowingly submit claims fraudulently, creating the need for laws that combat fraud and abuse and ensure appropriate quality medical care.
This webpage includes information to assist physicians in understanding how to comply with Federal laws by identifying “red flags” that could lead to potential liability in law enforcement and administrative actions.
All physicians participating in certain Medicare and Medicaid programs must receive training about compliance with CMS program rules. Physicians are required to complete general compliance and fraud, waste and abuse (FWA) training within 90 days of their initial enrollment in Sequent and subsequently repeat the training annually.
The following links are training documents that physicians can access to satisfy their compliance training. Upon completion of the training material, physicians are required to sign the FWA Training Attestation Form and return it to the Sequent Credentialing department.
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Training Material |
Overview and Training Objectives |
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Guidance related to ethical and legal standards at Northside Hospital to protect and promote system-wide integrity and to enhance Northside’s mission. |
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Medicare Parts C&D General Compliance Training Course
CMS Medicare Learning Network®
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Training material assists physicians and related personnel to satisfy their annual general compliance training requirements. Objectives include: · Recognize how a compliance program operates · Recognize how compliance program violations should be reported |
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Combating Medicare Parts C&D Fraud, Waste, and Abuse Training Course
CMS Medicare Learning Network®
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Training assists physicians and related personnel to satisfy their annual fraud, waste, and abuse (FWA) training requirements. Objectives include: · Recognize FWA in the Medicare Program · Identify the major laws and regulations pertaining to FWA · Recognize potential consequences and penalties associated with violations · Identify methods of preventing FWA · Identify how to report FWA · Recognize how to correct FWA |
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Document must be signed by the physician and returned to the Sequent Credentialing department. |
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Summary of CMS resources, references, laws and regulations, including links and descriptions related to CMS and OIG compliance program. |