Which of the following is an example of abuse as defined by CMS?

Abuse, as defined by the Centers for Medicare & Medicaid Services (CMS), involves practices that are inconsistent with accepted sound medical, business, or fiscal practices and lead to an unnecessary cost to the Medicare program. Charging excessively for services is a clear example of abuse because it indicates a practice that takes advantage of the payer and potentially harms the program by inflating costs without delivering appropriate value for the services rendered.

In situations where a provider imposes charges that are not aligned with the standard fees for similar services in the community, it can result in excessive billing that is not justified by the care provided. This practice fails to meet the ethical standards expected in healthcare and can lead to increased scrutiny from auditors and regulators.

The other options pertain to fraud or serious violations as they imply more severe misconduct, such as actively billing for services that were not provided or falsifying claims, which fall under fraudulent activity rather than abuse. Providing inadequate records for review highlights issues of compliance but does not fit the definition of abuse unless it results in overcharging or inflated claims. Thus, the charge of excessive billing exemplifies abusive practices in a healthcare setting, aligning with CMS’s broader guidelines on abuse.