Fraud and Abuse / Improper billing is one example of abuse

Article Overview

This article explains the Medicare concept of abuse and places it within the broader fraud-and-abuse compliance framework. It is relevant to providers, suppliers, coders, and compliance staff who need a general understanding of how improper billing and other noncompliant practices are viewed by Medicare and how such issues can escalate into fraud concerns. The content references Medicare guidance sources and discusses broad categories of abusive practices without providing operational coding instructions.