The American Journal of Managed Care

Further Research Into Medicare Advantage Upcoding, Documentation Accuracy Needed

Andrew S. Oseran, MD, MBA, MSc, hypothesizes that higher Medicare Advantage (MA) risk scores may result from either a more accurate capture of beneficiaries' comorbidities or inappropriate "upcoding" ...
The National Law Review

Upcoding Blues: $14.9 Million False Claims Act Settlement in Fraudulent Billing Qui Tam Lawsuit

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The National Law Review

Is Whistleblowing About Upcoding Protected Under the False Claims Act’s Anti-Retaliation ...

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The American Journal of Managed Care

Upcoding Emergency Admissions for Non-Life-Threatening Injuries to Children

For-profit status was found to influence the probability of upcoding for inpatient cases involving non-life-threatening injuries with implications for Medicaid and other insurers. Logistic regression ...