As defined by HIPAA...
Fraud is the "intentional deception or misrepresentation that someone makes, knowing it is false, that could result in an unauthorized payment." The attempt itself is considered fraud, regardless of whether it is successful.
Abuse "involves actions inconsistent with accepted, sound medical, business, or fiscal practices. Abuse directly or indirectly results in unnecessary costs to the program through improper payments."
The difference between fraud and abuse is the individual's intent; however, both have the same impact in that they steal valuable resources from the health care industry.
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