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Health care fraud law training offered at many med schools, residencies

The HHS Office of Inspector General also plans to provide educational materials on fraudulent billing, self-referral and the anti-kickback law.

By Carolyne Krupa — Posted Nov. 5, 2010

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More than two-thirds of residency and fellowship programs and 44% of medical schools offer training on Medicare and Medicaid fraud and abuse laws, according to a new federal report.

The Dept. of Health and Human Services' Office of Inspector General wants to step up voluntary compliance with federal laws by ensuring that physicians receive appropriate training on the front end.

"Medicare and Medicaid fraud and abuse cost U.S. taxpayers billions of dollars each year and put the programs' beneficiaries' health and welfare at risk," according to the October OIG report.

But since no law requires medical schools or graduate medical education programs to provide instruction on the laws, the first step was to determine how prevalent such lessons are. The OIG surveyed the country's 131 allopathic and 29 osteopathic medical schools, and 660 institutions with residency or fellowship training.

A total of 387 GME programs responded, with 68% saying they provide instruction covering issues such as fraudulent billing, self-referral and the anti-kickback statute. Of those, 38% said they provide the training annually, while 22% said the instruction is done during first-year residency training.

Among medical schools, the majority said the instruction occurs in the classroom, but more than half said the lessons were limited to two hours or less.

Such training ideally is offered during residency and fellowship training as physicians prepare for private clinical practice, said Ivy Baer, director and regulatory counsel with the Assn. of American Medical Schools' Health Care Affairs.

Even so, she said it's encouraging to see that many medical schools also offer the training.

"Fraud and abuse in the health care system -- while it's limited to few numbers of people -- it clearly does occur," Baer said. "People working in that system need to be aware of where the problems can be."

But medical schools and GME programs have a lot of material to cover in a limited time, and many may not have prepared lesson materials on the subject, Baer said.

In its report, the OIG concluded that it needs to develop and distribute additional educational materials on Medicare and Medicaid fraud and abuse to give medical schools and GME programs a "consistent starting point" (link).

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