Upcoding in Medicare has been a topic of interest to economists and policy makers for nearly 40 years. While upcoding … substantially over time, as has the published literature. Arguably, the primary importance of analyzing upcoding in different parts … upcoding. Financial estimates for upcoding in traditional Medicare (Medicare Parts A and B), are highly variable, in part …

Upcoding is a common type of fraud in healthcare. However, how audit policies need to be designed to cope with upcoding … switching from detectable to less gainful undetectable upcoding is not feasible. Implications for audit policies are discussed. …

Background: With DRG payments, hospitals can game the system by 'upcoding' true patient's severity of illness. This … paper takes into account that upcoding can be performed by the chief physician and hospital management, with the extent of …-agent mechanism, the distortion due to upcoding is shown to accumulate, whereas in the bargaining case it is avoided at the level of …

Background: With DRG payments, hospitals can game the system by ’upcoding’ true patient’s severity of illness. This … paper takes into account that upcoding can be performed by the chief physician and hospital management, with the extent of …-agent mechanism, the distortion due to upcoding is shown to accumulate, whereas in the bargaining case it is avoided at the level of …