How to Profit from Preventing Healthcare Fraud
What you'll learn
- Recently updated! Understand the COVID-19 implications for healthcare fraud
- Determine if they have a potential qui tam lawsuit against a suspected fraudulent healthcare provider
- Understand the nature and diversity of fraud and be able to recognize it in the workplace
- Articulate what a qui tam lawyer will need, and what will be required to convince the U.S. government to join her case
- Accept the "downside" of becoming a "whistleblower" and determine if this is a correct course of action for your particular situation
- Students will need audio and video capability, as well as Internet access. to participate in this unique learning experience.
This unique course has been updated to include information regarding COVID-19 and how response, recovery and emergency funds can be targeted for fraud. Although this course focuses on healthcare fraud, the principals are applicable to anyone who suspects, or is aware of, fraud against the U.S. government. The Government is taking aggressive enforcement action against those who attempt to defraud the American taxpayer. This course describes how the False Claims Act (FCA) is used by the Department of Justice (DOJ) to stop fraudulent claims and how you can receive significant financial awards for assisting in this process.
According to the DOJ, more than $2.2 billion in settlements and judgements were recovered in 2020. Over $1.8 billion dealt with the healthcare industry.
The course covers:
What is fraud? What are examples of healthcare fraud?
The scope of healthcare fraud and the threat it poses to Americans.
Why the government needs the help of "insiders" in fighting fraud.
The legal concepts that allow citizens to be financially rewarded for helping the government fight fraud.
What to expect as a "whistle-blower."
Selecting an appropriate attorney
Examples of whistle-blower financial awards
Reality Check: The downside of deciding to blow the whistle
The course also explains the legal concept of “Qui tam." This is a provision in the federal False Claims Act that encourages private citizens to file sealed lawsuits in federal court that seek recovery of government money obtained by fraud, or more specifically, false claims. It is an incredibly powerful law. The law also allows citizens to receive a portion of the recovered funds. These awards can often reach into millions of dollars.
The term “qui tam” is Latin shorthand for "he who pursues this action on our Lord the King’s behalf as well as his own.”
Whether you are in healthcare or not, you will learn the basics of filing a "Qui tam" legal action. This includes:
The requirement to have an attorney
What an attorney will require from you
How the government may, or may not, "join" your case
Expectation Management (i.e. it isn't easy. it isn't fast)
Who this course is for:
- Employees engaged in any form or healthcare. This includes hospitals, physician practices, manufacturers, vendors, consultants, coding specialists, office managers, receptionists, nurses, medical assistants, security officer, risk management specialists, physicians, and healthcare consumers
- The concepts covered in this course are focused on healthcare fraud. However, the general principals are relevant to any employee, in any industry, that does business with the government and suspects fraud.
I have over 40 years experience as a security professional in a diverse array of environments, including military, Fortune 500 high-technology firms, homeland security, and most recently, as the director of security for a metropolitan hospital network.
I have taught graduate-level security management as an adjunct faculty member of Webster University. I served 20 years in the United States Air Force in a number of capacities, including security, intelligence, and air operations. I have also served as a logistics advisor to two foreign governments (Canada and the Republic of Singapore)
Internationally published, my work has appeared in a wide-array of trade and professional periodicals, including Security Management, Police, and Airpower Journal.
Education includes a BA (summa cum laude) in Criminal Justice from Rowan University and a Masters of Public Administration (MPA) from Troy State University.
Professional credentials include the Certified Protection Professional (CPP) designation under the auspices of the American Society for Industrial Security (ASIS, International)
Additionally, I maintain the credential of Certified Healthcare Protection Administrator (CHPA) under the authority of the International Foundation for Healthcare Security and Safety (IAHSS).
Finally, I am the author of Udemy's course, How to Succeed in your Security Career, which is currently nearing 2,000 global students.