Author: Kelly Heskett BS, CLS, RN, BSN, CEN

Target Audience: RNs interested in learning more about legal nurse consulting and the LNC role in health care provider investigations, administrative proceedings, and fraud

Description/Purpose: Participation in this online module will increase the learner’s knowledge on Healthcare Provider Investigations and the LNC role in administrative proceedings and fraud litigation.

Learning Objectives:

• Explain the purpose of practice acts in regulating health professionals
• Discuss the laws governing the investigative process and administrative proceedings
• Detain the composition and function of a professional licensing board
• List the penalties a professional licensing board can impose
• Recall the types of complaints that can initiate an administrative investigation
• Examine the legal nurse consultant's role in the prosecution and defense of *healthcare provider licensure investigations and administrative proceedings
• Describe the mechanics of healthcare reimbursement
• Discuss the elements of fraud within the context of healthcare
• Develop a case evaluation infrastructure for government and privately sponsored health plans

Continuing Education: The American Association of Legal Nurse Consultants is accredited as a provider of continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Contact Hours:2.0

Expiration Date: November 15, 2026

Successful Completion:

• Complete individual module and activities
• Obtain a score of at least 80% on the module post-test
• Complete the online course evaluation and attestation of completion