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A Roadmap for New Physicians

Avoiding Medicare and Medicaid Fraud and Abuse

Physician Education Training Materials

The Office of Inspector General (OIG) for the U.S. Department of Health & Human Services has created the educational materials listed below to assist in teaching physicians about the Federal laws designed to protect the Medicare and Medicaid programs and program beneficiaries from fraud, waste, and abuse.

  • A Roadmap for New Physicians (PDF), which is a booklet for physicians' self-study.
  • A companion PowerPoint presentation (PPT) that we encourage you to use to teach the material contained in the Roadmap.
  • The speaker note set (PDF), which will assist you in giving the PowerPoint presentation.
  • For physicians who may be unable to attend a live, didactic presentation of the material contained in the Roadmap, we also have provided a narration of the speaker notes to accompany the PowerPoint slides.

The following presentation summarizes the five main Federal fraud and abuse laws (the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law) and provide tips on how physicians should comply with these laws in their relationships with payers (e.g., the Medicare and Medicaid programs), vendors (e.g., drug, biologic, and medical device companies), and fellow providers (e.g., hospitals, nursing homes, and physician colleagues).

These materials summarize the five main Federal fraud and abuse laws (the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law) and provides tips on how physicians should comply with these laws in their relationships with payers (e.g., the Medicare and Medicaid programs), vendors (e.g., drug, biologic, and medical device companies), and fellow providers (e.g., hospitals, nursing homes, and physician colleagues).

OIG hopes you find these free educational materials helpful and appreciates your willingness to educate physicians about fraud, waste, and abuse.

Physicians can earn Category 1 continuing medical education (CME) credit by completing the Avoiding Medicare Fraud and Abuse: A Roadmap for Physicians course from the Medicare Learning Network. Learn more.

DISCLAIMER

These educational materials were current at the time they were published and uploaded onto OIG's Web site. They were prepared as tools to assist in teaching physicians; they are not intended to create any rights, privileges, or benefits. Although every reasonable effort has been made to assure the accuracy of the information within these materials, the ultimate responsibility for complying with the Federal fraud and abuse laws lies with the provider of services. OIG employees, agents, and staff make no representation, warranty, or guarantee that these compilations of information are error free and will bear no responsibility or liability for the results or consequences of the use of these materials. These educational materials are summaries that explain certain aspects of the Federal fraud and abuse laws, but are not legal documents. The official information is contained in the relevant laws and regulations.