What term describes actions that lead to unnecessary costs to a federal healthcare program?

The term that describes actions leading to unnecessary costs to a federal healthcare program is 'abuse.' In the context of healthcare, abuse refers to practices that are inconsistent with sound fiscal, business, or medical practices and are likely to result in unnecessary costs to the federal healthcare program. This can include over-utilization of services, billing for services that were not medically necessary, or improper billing practices that do not constitute fraud but still lead to wasteful spending.

While fraud involves intentional deception to gain unauthorized benefits, abuse typically involves actions that may be careless or unintentional, but nonetheless result in excessive costs. It's important to differentiate between these concepts, as they have different implications for compliance and regulation within healthcare systems. Abuse can encompass a wide range of practices and can arise from poor practices rather than deliberate fraud, making it a broader category associated with financial waste in healthcare programs.