Fraud Prevention 💻

We all have seen the news and we may feel anxious or scared about our organizations. We want to be providers that operate with integrity and transparency! Preventing fraud is a responsibility that is vital to the ongoing health of an organization and the services provided. Too often fraud occurs because of lack of systems, oversight, and accountability. As a Medicaid provider, you are required to have fraud prevention measures in place. Every 245D licensed provider needs a Designated Manager (DM) and Public Funds Compliance Officer (PFCO) and both are responsible for ensuring public funds are being used correctly. These two positions and the organization as a whole must implement strategies to prevent and respond to fraud.

Topics:

• The difference between public and private monies
• Define fraud and explore examples of fraud through all levels of the program
• The Fraud Triangle
• Practical and preventative measures and systems (including evaluation techniques)
• Identify the roles and responsibilities of the DM and PFCO regarding fraud prevention and response
• Reporting and reactive measures to address suspicious activity or allegations of fraud

Audience: Designated Managers, Public Funds Compliance Officers, and anyone who takes responsibility for the financial management of the program.

CEU Contact Hours: 1.8 for Nurses, 1.5 for Social Workers

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