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Fraud, Waste, and Abuse Compliance

The Centers for Medicare and Medicaid Services requires that all Medicare/Medicaid providers and their staff (including those that participate in Delta Dental’s Healthy Kids program) take the CMS training for Fraud, Waste and Abuse Prevention and General Compliance. This training can be taken directly on the CMS website through the Medicare Learning Network or through Delta Dental, which provides the same exact training module. CMS mandates that its content not be modified.

In addition to Fraud, Waste and Abuse and General Compliance Training, Section 6401 of the Affordable Care Act requires that a “provider of medical or other items or services or supplier within a particular industry sector or category” shall establish a compliance program as a condition of enrollment in Medicare, Medicaid, or the Children’s Health Insurance Program. Practices can use the Office of the Inspector General guidance to create its own written Compliance Program.

The Michigan Dental Association endorses Eagle Associates, which offers a Compliance Program in a special bundle of services.