What Is Abuse?
Abuse involves incidents or unintentionally practices that are:
- not medically necessary as defined by Medicare guidelines; or
- inconsistent with accepted sound medical, business or fiscal practices.
Abuse can be identified when individuals unintentionally follow practices that result in unnecessary Medicare Program costs. Abusive practices may develop into fraud and be prosecuted as such.
Examples of abuse include:
- Unbundling charges
- Claims for services not medically necessary (to the extent furnished)
- Incorrectly apportioning costs on cost reports
- Violation of the Medicare Participation agreement
- Routine waiver of coinsurance and deductibles
- Improper or sloppy billing practices
UPIC Contact Information
UPIC Western
Qlarant Integrity Solutions, LLC
Qlarant Website
States: Alaska, Arizona, American Samoa, California, Guam, Hawaii, Idaho, Montana, Nevada, North Dakota, Northern Marianas Islands, Oregon, South Dakota, Utah, Washington, Wyoming
UPIC Midwestern
CoventBridge Group
CoventBridge Group Website
States: Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin
UPIC Southwestern
Qlarant Integrity Solutions, LLC
Qlarant Integrity Solutions Website
States: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas
UPIC Northeastern
Safeguard Services, LLC
Safeguard Services Website
States: Pennsylvania, New York, Delaware, Maryland, D.C., New Jersey, Massachusetts, New Hampshire, Vermont, Maine, Rhode Island, Connecticut
UPIC Southeastern
Safeguard Services, LLC
Safeguard Services Website
States: Alabama, Florida, Georgia, North Carolina, Puerto Rico, South Carolina, Tennessee, Virgin Islands, Virginia, West Virginia
OIG Hotline Operations
UPIC Contact Information
UPIC Western
Qlarant Integrity Solutions, LLC
Qlarant Website
States: Alaska, Arizona, American Samoa, California, Guam, Hawaii, Idaho, Montana, Nevada, North Dakota, Northern Marianas Islands, Oregon, South Dakota, Utah, Washington, Wyoming
UPIC Midwestern
CoventBridge Group
CoventBridge Group Website
States: Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin
UPIC Southwestern
Qlarant Integrity Solutions, LLC
Qlarant Integrity Solutions Website
States: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas
UPIC Northeastern
Safeguard Services, LLC
Safeguard Services Website
States: Pennsylvania, New York, Delaware, Maryland, D.C., New Jersey, Massachusetts, New Hampshire, Vermont, Maine, Rhode Island, Connecticut
UPIC Southeastern
Safeguard Services, LLC
Safeguard Services Website
States: Alabama, Florida, Georgia, North Carolina, Puerto Rico, South Carolina, Tennessee, Virgin Islands, Virginia, West Virginia
OIG Hotline Operations
UPIC Contact Information
UPIC Western
Qlarant Integrity Solutions, LLC
Qlarant Website
States: Alaska, Arizona, American Samoa, California, Guam, Hawaii, Idaho, Montana, Nevada, North Dakota, Northern Marianas Islands, Oregon, South Dakota, Utah, Washington, Wyoming
UPIC Midwestern
CoventBridge Group
CoventBridge Group Website
States: Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin
UPIC Southwestern
Qlarant Integrity Solutions, LLC
Qlarant Integrity Solutions Website
States: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas
UPIC Northeastern
Safeguard Services, LLC
Safeguard Services Website
States: Pennsylvania, New York, Delaware, Maryland, D.C., New Jersey, Massachusetts, New Hampshire, Vermont, Maine, Rhode Island, Connecticut
UPIC Southeastern
Safeguard Services, LLC
Safeguard Services Website
States: Alabama, Florida, Georgia, North Carolina, Puerto Rico, South Carolina, Tennessee, Virgin Islands, Virginia, West Virginia
OIG Hotline Operations
UPIC Contact Information
UPIC Western
Qlarant Integrity Solutions, LLC
Qlarant Website
States: Alaska, Arizona, American Samoa, California, Guam, Hawaii, Idaho, Montana, Nevada, North Dakota, Northern Marianas Islands, Oregon, South Dakota, Utah, Washington, Wyoming
UPIC Midwestern
CoventBridge Group
CoventBridge Group Website
States: Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin
UPIC Southwestern
Qlarant Integrity Solutions, LLC
Qlarant Integrity Solutions Website
States: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas
UPIC Northeastern
Safeguard Services, LLC
Safeguard Services Website
States: Pennsylvania, New York, Delaware, Maryland, D.C., New Jersey, Massachusetts, New Hampshire, Vermont, Maine, Rhode Island, Connecticut
UPIC Southeastern
Safeguard Services, LLC
Safeguard Services Website
States: Alabama, Florida, Georgia, North Carolina, Puerto Rico, South Carolina, Tennessee, Virgin Islands, Virginia, West Virginia
OIG Hotline Operations