Medicare Compliance: Fraud and Abuse

Healthcare fraud and abuse cost the U.S. healthcare system an estimated $300 billion annually — a burden that ultimately drives up premiums, reduces benefits, and increases the cost of doing business for employers across both the private and public sectors. This course is designed for all employees and managers working in healthcare organizations who need a solid understanding of the laws, responsibilities, and protections surrounding healthcare fraud and abuse.

The course provides a comprehensive overview of the principal federal laws used to combat fraud against government healthcare programs, including the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Fraud Enforcement and Recovery Act, the Affordable Care Act, and the Deficit Reduction Act. Learners will explore how to identify the elements of healthcare fraud and abuse, understand the difference between the two, and recognize conduct that could trigger liability.

The course also covers employer responsibilities in establishing compliance programs to prevent false claims, as well as the practical steps employees can take to avoid violations in their day-to-day roles. A dedicated section addresses whistleblower rights and protections, ensuring learners understand both their right and their responsibility to report suspected fraud and abuse.

Upon completion, employees will be equipped to recognize fraud risks, support their organization's compliance efforts, and contribute to protecting the integrity of government healthcare programs.

Our Story: From Service Members to Service Providers

Evolve eLearning Solutions started in 2003 with a simple observation: compliance training didn’t have to be painful. Founded by veterans of the United States Marine Corps and Navy, we brought a service-first mentality to an industry that often felt like an afterthought.

In the military, training isn’t optional—it’s how you stay mission-ready. We saw organizations struggling with the same challenge: keeping teams trained, compliant, and confident without derailing daily operations. The solutions available were either overpriced, overcomplicated, or both.

So, we built something different. Training that respects people’s time. Support that actually solves problems. Pricing that makes sense for real budgets. No enterprise sales pitches, no feature bloat—just effective compliance training delivered by people who understand what it means to serve.

Two decades later, that approach hasn’t changed. We’ve grown from a handful of courses to a comprehensive library covering OSHA, HIPAA, HR/EEO, and more. But we’re still the same team that picks up the phone, remembers your name, and treats your compliance challenges like they matter—because they do.