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- Medicare Fraud, Waste, Abuse - 2025 Flashcards | Quizlet
Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly or intentionally misrepresented facts to obtain payment True
- [FREE] True or False? Abuse involves paying for items or services when . . .
The answer to the question is True; abuse involves making payments without legal entitlement and without the provider's intentional misrepresentation Understanding abuse is important to distinguish it from fraud, which includes an intention to deceive
- FINAL ASSESSMENT True or False? Question 8. | StudyX
Abuse involves actions that may directly or indirectly result in unnecessary costs to a program Abuse often involves improper behavior that is inconsistent with standard fiscal or business practices The statement is false The definition provided describes "waste "
- Fraud, Waste and Abuse - IEHP
Abuse includes actions that may, directly or indirectly, result in unnecessary costs, improper payment, payment for services that fail to meet professionally recognized standards of care, or services that are medically unnecessary
- Provider Fraud, Waste Abuse Training - UPMC Health Plan
ABUSE: Includes action that may, directly or indirectly, result in unnecessary costs Abuse involves payment for items or services when there is not legal entitlement to that payment and the provider has not knowingly and or intentionally misrepresented facts to obtain payment
- 18 – Fraud, Waste and Abuse Compliance Policy
Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and or intentionally misrepresented facts to obtain payment
- Fraud, Waste and Abuse (FWA) | Memorial Hermann Health Plan
Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and or intentionally misrepresented facts to obtain payment
- Abuse involves payment for items or services | StudyX
Simply receiving payment without legal entitlement, without any deceptive actions by the provider, doesn't meet the definition of abuse It might be an error, an oversight, or a misunderstanding, but not necessarily abuse
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