“Upcoding” Has Cost Medicare $70 Billion

On Monday, an audit by the Government Accountability Office (GAO) reported Medicare Advantage plans have overbilled the government by $70 billion from 2008 through 2013. The plans received inflated fees by overstating patients’ health risks in the billing formula called a “risk score” which pays higher rates for sicker patients and less for people in good health, in medical circles this practice is known as “upcoding”. Read article here……

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