The page below is a sample from the LabCE course Medicare Compliance for Healthcare Personnel. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Medicare Compliance for Healthcare Personnel (online CE course) »
How to Subscribe

Fraud and Abuse, continued

Abuse describes practices that result in unnecessary costs to the Medicare Program. Abuse includes any practice that is not consistent with the goals of providing patients with services that are medically necessary, meet professionally recognized standards, and are priced fairly.
Examples of Medicare abuse include:
  • Billing for services that were not medically necessary
  • Charging excessively for services or supplies
  • Misusing codes on a claim, such as upcoding or unbundling codes
Medicare fraud and abuse exposes healthcare providers to criminal and civil liability.