Upcoding Crackdown: Federal Efforts Fail to Benefit Private Insurers

For more than a decade, taxpayer-funded health care programs have seen a steady uptick in higher-paying billing codes. Office visits, outpatient services, and emergency room care have all been billed at progressively higher reimbursement codes, raising fees by billions of dollars. Many providers contend the shift is the result of sicker patients coupled with the

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Largest Single Healthcare Fraud Case in U.S. History

The U.S. Justice Department just recently indicted three Florida residents in the “largest single criminal healthcare fraud case ever brought against individuals.” While the case has not gone to trial yet, the numbers are staggering. It is alleged that over $1 billion in Medicare and Medicaid billings were fraudulently charged by just a few co-conspirators –

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