Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care

benefit program, or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the

money or property owned by, or under the custody or control of, any health care benefit program. The Health Care Fraud

Statute makes it a criminal offense to knowingly and willfully execute a scheme to defraud a health care benefit program. This applies to the fraudulent completion and submission of

timesheets/cards in order to collect payment for hours not worked.

Waste includes overusing services, or other practices

that, directly or indirectly, result in unnecessary costs

to the Medicare Program. Waste is generally not considered to be caused by criminally negligent but rather by the misuse of resources. (CMS)

Abuse includes actions that may, directly or indirectly,

result in unnecessary costs to the Medicare Program.

Abuse involves payment for items or services when there is not legal entitlement to that payment and the

provider has not knowingly and/or intentionally misrepresented facts to obtain payment. (CMS)