Health care fraud, waste and abuse is a national problem that affects all of us either directly or indirectly. National estimates project that billions of dollars are lost to health care fraud, waste and abuse on an annual basis. These losses lead to increased health care costs and potential increased costs for coverage.
Health care fraud is an intentional misrepresentation, deception, or intentional act of deceit for the purpose of receiving unwarranted payment in part or in whole.
Health care abuse is reckless disregard or conduct that goes against and is inconsistent with acceptable business and/or medical practices resulting in unnecessary costs.