"Compliance Hot Topic: Fraud, Waste, and Abuse"

Fraud, waste, and abuse (FWA) remains among the most significant challenges facing the U.S. healthcare system, costing billions of dollars annually while increasing compliance risk, driving up healthcare costs, and undermining trust in healthcare programs. As federal and state regulators continue to enhance their oversight and enforcement efforts, healthcare providers must understand the evolving FWA landscape and proactively align their compliance and monitoring activities with government priorities.

This session will provide healthcare leaders, compliance professionals, auditors, and operational stakeholders with an overview of current FWA risks, emerging enforcement trends, and the key areas receiving increased scrutiny from regulators and law enforcement agencies. Attendees will gain insight into how organizations such as the Department of Justice (DOJ), Office of Inspector General (OIG), and Centers for Medicare & Medicaid Services (CMS) are identifying, investigating, and addressing improper billing, documentation deficiencies, kickbacks, and other program integrity risks.

Learning Objectives

By the end of this session, participants will be able to:

1. Understand the government's current priorities for addressing healthcare fraud, waste, and abuse.

2. Identify specific risk areas most likely to attract regulatory scrutiny.

3. Evaluate lessons learned from recent enforcement actions and program integrity initiatives.

4. Develop practical strategies to enhance compliance oversight and align internal resources with FWA risk priorities.