Home Health & Hospice

Q: Can you define fraud and abuse? How are they different?

Homecare Insider, May 6, 2013

Q: Can you define fraud and abuse? How are they different?

A: Fraud is knowingly billing for services that were not furnished and/or supplies not provided, and altering claims and/or receipts to receive a higher payment amount.

Abuse describes practices that, directly or indirectly, result in unnecessary costs, including any practice that is not consistent with the goals of providing patients with services that are medically necessary, meet professionally recognized standards, and are fairly priced.

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