US federalRequired by law42 CFR §422.503(b)(4)(vi)(C)

Medicare fraud, waste & abuse (FWA)

A ready-made course you customise for your organisation, with a live session deck and two surveys. You only add the 8 details that are specific to your organisation.

See the live deckSee the full outline
Try the coursePreview the survey
Length
35 min
Lessons
7 lessons
Frequency
Within 90 days of hire/contract + annually
Last reviewed
8 Oct 2026
Case practice
What would you do?

Plan call-center rep hears a broker enrolled a member who "never agreed"

Try it: this is one of 15 interactive activities in the course.

What's included

Three pieces that work together

Copy once, get everything. Learners prepare on their own, you answer questions live, and the surveys tell you what stuck.

Self-paced course

Short lessons with real workplace scenarios, not walls of text.

  • 7 lessons, about 35 minutes
  • 2 video slots (you add the videos)
  • Accordion, flashcards, scenario, tabs and quizzes
  • 12-question final check, 80% to pass

Live session deck

An AhaSlides presentation to run after the course, in person or online.

  • 11 slides
  • Quiz, poll, word cloud, scale slides
  • A closing slide for your contacts

Two surveys

Find out what landed, and whether people use it on the job.

  • Post-course feedback, about 2 minutes
  • 30-day check-in
  • Anonymous by default
  • Results feed your next refresher

Learning objectives

At the end of this course, learners can

Built to the law Each objective names the requirement it comes from and the lesson that covers it.

IDObjectiveRequired byWhere it's covered
TO 1.0Achieve ≥ 80% on the final assessment-Whole course
LO 49.1.1Explain why FWA programs exist and the cost of non-compliance§422.503(b)(4)(vi)Lesson 1: Why the rule exists
LO 49.2.1Distinguish fraud, waste and abuse with examplesCMS definitionsLesson 2: Fraud, waste or abuse?
LO 49.3.1Apply key laws: FCA, AKS, Stark, exclusion, CMP, criminal fraud31 USC 3729; 42 USC 1320a-7bLesson 3: The laws in brief
LO 49.4.1Recognise FWA red flags among members, providers, pharmacies and plansCh. 21/9Lesson 4: Red flags
LO 49.5.1Check exclusion status and avoid conflicts42 CFR 1001; LEIELesson 5: Case practice
LO 49.6.1Report suspected FWA through internal and external channels; know non-retaliation + your info§422.503(b)(4)(vi)(D), (G)Lesson 6: Escalate correctly

Your part: what a template can't do for you

  • Your workplace details: fill in the 8 highlighted fields so the course describes your own policies, contacts and locations.
  • Records: record completion in your own LMS or record system.

Course outline

7 lessons, about 35 minutes

Minutes per lesson are an estimate, shared out by page count.

ContentInteractiveVideoYou customise
1

Why the rule exists

3 pages

7 min
Before you beginNoteList
The phantom scooterKey factVideo
ConsequencesAccordionQuiz
2

Fraud, waste or abuse?

2 pages

4 min
DefinitionsTabs
Sort itSorting activityQuiz
3

The laws in brief

3 pages

6 min
Key lawsFlashcards
Exclusion screeningTableYour info
CheckMatching quiz
4

Red flags

3 pages

6 min
By actorAccordion
Pharmacy red flagsFlashcards
CheckMulti-select quiz
5

Case practice

2 pages

4 min
Scenario 1Scenario
Scenario 2ScenarioQuiz
6

Escalate correctly

2 pages

4 min
Where to reportProcessYour infoYour infoTableKey fact
CheckQuiz
7

Final assessment

Assessment

4 min
Final check12 questions80% to passCompletion page

Live deck and surveys

11 slides to run live, two surveys to close the loop

Pink slides are interactive. Both surveys are anonymous; pink questions are written for this course.

TitleTitle + agenda
QuizFraud, waste or abuse? - duplicate test by habit
QuizA lab offers $50 per referral - which law?
PollWhere would you report first?
Content · customiseOur compliance program in 3 points
Word cloudA red flag you've heard of
Quiz · customiseHow often is exclusion screening done here?
ScaleI'd feel safe reporting suspected fraud.
Open-endedWhich process feels most at risk?
Q&AAsk the trainer anything
Closing · customiseHotline
Post-course feedback: 11 questions, about 2 min
  1. Overall rating 5 stars
  2. Relevant, realistic, right length, helpful activities agree/disagree grid
  3. What was most useful? multi-select
  4. Confidence before this course, and now 1-5 scale
  5. Which of these do you handle? multiple choice
  6. How confident are you telling fraud apart from waste or abuse? 1-5 scale
  7. Which red flag example felt most relevant to your work? short text
  8. People here can raise compliance concerns without fear of retaliation. 1-5 scale
  9. One thing we should change or add open text
  10. Would you recommend this course? NPS
30-day check-in
  1. Have you used what you learned since the course? multiple choice
  2. How confident are you today? Compare with day 1 1-5 scale
  3. Do you know where to find our compliance hotline and compliance officer? yes / no / not sure
  4. A moment where the training helped, or where you weren't sure open text
  5. Which topics should the next refresher focus on? ranking

Results show whether people use the training on the job, not just whether they finished it.

Make it yours

8 fields to fill in, and you're ready

Everything else is done. These are the details only your organisation knows; each one is highlighted inside the course.

  • Compliance officer contact{{COMPLIANCE_OFFICER_CONTACT}}
  • Anonymous hotline{{ANONYMOUS_HOTLINE}}
  • Plan sponsor siu contact{{PLAN_SPONSOR_SIU_CONTACT}}
  • Screening process{{SCREENING_PROCESS}}
  • Code of conduct link{{CODE_OF_CONDUCT_LINK}}
  • Conflict of interest form{{CONFLICT_OF_INTEREST_FORM}}
Show all 8 fields
  • LMS or record system{{LMS_OR_RECORD_SYSTEM}}
  • Survey URL{{SURVEY_URL}}

FAQ

Common questions

Can I run Medicare fraud, waste & abuse (FWA) training online?

The course itself is self-paced and online, and the live deck lets you add a live session. Whether online delivery meets your local rules depends on the law that applies to you, so check 42 CFR §422.503(b)(4)(vi)(C) or ask your own counsel.

How often is this training needed?

Within 90 days of hire/contract + annually (verify in current Ch. 21/9); records retained 10 years.

Who needs this training?

Employees, managers, board members of Medicare Advantage (Part C) and Part D plan sponsors; FDRs (pharmacies, PBMs, call centers, provider billing staff) where the sponsor's contract requires it.

What records should I keep?

Record completion in your own LMS or record system, so you can show who finished the course and when. Check the retention period that applies to you in 42 CFR §422.503(b)(4)(vi)(C).

Can I edit the content?

Yes, everything. Change the wording, swap scenarios for ones from your workplace, add your logo, or remove parts that don't apply. Keep anything your own law requires you to cover.

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Last reviewed: 8 October 2026Based on: 42 CFR §422.503(b)(4)(vi)(C), §423.504(b)(4)(vi)(C) (effective training and education); Medicare Managed Care Manual Ch.…Templates are a starting point, not legal advice.

Ready to run it?

Open the live deck to see how the session runs alongside the course and both surveys.

See the live deck