INVS 4309 - Healthcare Fraud, Waste, and Abuse Compliance Failures

The Office of Inspector General (OIG) publishes model compliance guidelines and comments frequently on various compliance measures providers can take to ensure they do not run afoul of the various healthcare fraud statutes. This course will focus not only on the OIG guidance, but on the ramifications of failing to maintain a proper compliance program. A specific focus will be on a large, publicly-funded medical school and its associated healthcare system, and the failure of that system to maintain a proper and quality compliance program. The case study will demonstrate how proper compliance measures work to foster proper billing, coding, and compliance. 3 credits.