Significant Upcoding Risks Emerge with Medicare Advantage

significant upcoding risks emerge with medicare advantage

Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”

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How to Align Physician Satisfaction and Compliance

  Fraud is still a very real issue across the relationships between physicians and hospitals Is it possible to align physician satisfaction and compliance? According to Gail Peace, President of Ludi Inc., “Regardless of the physician being independent or employed by a hospital, there are a myriad of regulations to navigate in these relationships.” She […]

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