What term would be used for actions that result in unnecessary costs to the Medicare program?

Study for the HCCA Certified in Healthcare Compliance (CHC) Exam. Practice with interactive questions and detailed explanations. Get ready to excel in your field!

The term that describes actions resulting in unnecessary costs to the Medicare program is "waste." Waste refers specifically to over-utilization of services or other practices that, while not necessarily illegal, lead to inefficient use of resources. This can include excessive or unnecessary services that do not provide any additional benefit to the patient but contribute to unnecessary expenditure.

In the context of Medicare, waste might manifest as billing for services that aren't needed or providing services in a more expensive manner when a less costly option would suffice. It's important to distinguish this from actions that are deemed fraudulent, which involve intentional deception, or abusive actions that may not be designed to defraud but still result in unnecessary costs. Mistakes are genuine errors and do not imply intent to misuse resources. Thus, waste captures the essence of unnecessary costs stemming from inefficiencies in service delivery without implicating outright fraud or intentional misconduct.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy