Ethics in Action: Protecting Clients and Yourself from Fraud, Waste, and Abuse

Fraud, waste, and abuse (FWA) in behavioral health is more than a compliance issue—it directly impacts clinical care, client trust, and the sustainability of programs. This training will provide professionals with a framework to recognize, prevent, and address FWA across organizational levels. Participants will examine common pitfalls, including documentation errors, billing missteps, and boundary violations, that may inadvertently escalate into compliance violations or ethical breaches. Through case examples drawn from provider audits, criminal justice intersections, and real-world practice, attendees will learn how to identify red flags without losing sight of the human impact of their decisions. The session will also highlight evidence-based best practices in internal monitoring, corrective action planning, and fostering a culture of compliance that protects both clients and providers. Goals include increasing professional confidence in distinguishing between human error and intentional misconduct, improving documentation practices that withstand audit scrutiny, and equipping attendees with actionable strategies to integrate fraud-prevention safeguards into everyday practice. By the end of the session, participants will be able to: (1) articulate the core definitions of fraud, waste, and abuse in behavioral health, (2) apply risk-based strategies to reduce vulnerabilities in documentation and billing, and (3) implement proactive supervisory techniques to support staff in ethical and compliant care delivery. This training integrates compliance oversight with clinical realities, offering participants a clear roadmap to protect their organizations, staff, and—most importantly—the people they serve.

 

Category
Best Practices
Clinical
Co-Occurring
Ethics
Intermediate
Peer

Speakers

GCHayden.pic
Gloria Cudicio-Hayden, MS, CAADC

Gloria Cudicio-Hayden is a compliance professional specializing in fraud, waste, and abuse (FWA) detection and prevention within behavioral health systems. She currently works in compliance and fraud oversight, with experience spanning audits, investigations, provider monitoring, and regulatory risk mitigation. Previous roles include Director, Clinical Director and Assistant Clinical Director supporting individuals with Mental Health Disorders, Substance Use Disorders, and Intellectual Disabilities.  Gloria holds a master’s degree in forensic psychology and is a Certified Advanced Alcohol and Drug Counselor (CAADC). Her work bridges clinical operations and compliance strategy, with a focus on identifying systemic vulnerabilities before they escalate into regulatory or financial exposure. Gloria is particularly interested in strengthening organizational accountability, ethical leadership, and sustainable compliance frameworks in complex healthcare environments.