In CMS identified areas of high-risk fraud, which combination does NOT apply?

In the context of CMS identified areas of high-risk fraud, the correct answer highlights a key understanding of what constitutes significant fraudulent activities in the healthcare system. Billing for services not rendered is indeed a recognized high-risk fraud area, as is over-utilization. However, the combination presented in the response suggests a lack of knowledge about how these elements interplay within fraud frameworks.

Increased beneficiary complaints, such as those arising from improper billing, reflect a clear indicator of potential fraud and abuse. Geographical billing changes and identity theft are also key elements that raise flags for potential fraudulent practices in healthcare billing and reimbursement processes.

By understanding the nature of fraud in healthcare, it becomes clear that each of the other combinations mentioned embodies concerns that CMS consistently monitors for fraudulent behavior. The distinction lies in recognizing that both billing practices and patterns of service usage, along with the reactions of beneficiaries to these practices, form an essential part of identifying and mitigating fraud risks effectively. This understanding underscores the importance of vigilance and comprehensive oversight in preventing healthcare fraud.