Understand Fraud, Waste, and Abuse (FWA) Regulations
FWA is a crucial part of the AHIP certification exam, and it’s essential to understand the measures that are in place to prevent fraudulent activities in the health insurance industry. Be familiar with the following:
- FWA Laws and Regulations: Learn about the different laws governing fraud, Free Ahip Certification waste, and abuse, including the False Claims Act, the Anti-Kickback Statute, and the Stark Law.
- FWA Prevention Techniques: Understand how insurance carriers and government agencies detect and prevent FWA, as well as your role as an agent in reporting suspicious activities.
- FWA Penalties: Be aware of the penalties associated with FWA violations, which can include hefty fines, imprisonment, and exclusion from federal health programs.
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