Medicare and Medicaid Fraud and Abuse Training in Medical Education

Forty-four percent of medical schools reported providing instruction to students on Medicare and Medicaid fraud and abuse laws in 2010. Furthermore, more than two-thirds of institutions offering residency and fellowship programs reported instructing participants on compliance with Medicare and Medicaid fraud and abuse laws in 2010.

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. No current law requires medical schools or hospitals offering physician residency or fellowship programs to provide instruction on compliance with Medicare and Medicaid laws aimed at preventing fraud and abuse. OIG has dedicated significant resources to promoting the adoption of compliance programs and encouraging health care providers to incorporate integrity safeguards into their organizations as an essential component of a comprehensive antifraud strategy.

Among the Federal statutes addressing fraud and abuse are the civil False Claims Act, the anti-kickback statute, and the physician self-referral statute. For this report, we surveyed all accredited allopathic and osteopathic medical schools and institutions offering physician residency and fellowship programs to determine the extent to which they provided instruction on compliance with these three laws.

We found that about two-thirds of the medical schools that provided instruction specifically reported covering the False Claims Act, the physician self-referral law, and the anti-kickback statute. Over three-quarters of the institutions that provided instruction reported covering these laws. Almost all medical schools and institutions offering residency and fellowship programs are interested in receiving OIG-provided instructional materials relating to Medicare and Medicaid fraud and abuse.

Opportunities exist for OIG to provide additional educational materials addressing these topics. OIG plans to (1) prepare educational materials appropriate for medical schools and institutions offering residency and fellowship programs, (2) distribute the materials to those medical schools and institutions that sponsor residency and fellowship programs, and (3) seek feedback from the medical schools and institutions offering residency and fellowship programs on ways to improve the materials. Such feedback could include emerging compliance challenges that physicians, hospitals, and other providers face.


HHS OIG Medicare and Medicaid Fraud and Abuse Training in Medical Education