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Presentation
Implications of Upcoding on Medicare Fraud
Faculty Research Day
  • Alberto Coustasse, Marshall University
  • Katrina Cremeans, Marshall University
  • Carli Followay, Marshall University
  • Jessica Oldaker, Marshall University
Location
Marshall University
Event Website
https://ensemble.marshall.edu/Watch/Hz3i2MSg
Start Date
9-11-2018 10:50 AM
End Date
9-11-2018 11:10 AM
Disciplines
Description

The complexity of and quantity of funds involved in Medicare reimbursements have led to a significant increase in the number of Medicare fraud. A particular kind of Medicare fraud, upcoding, has contributed to excessive and avoidable health care spending. Upcoding has been an illegal tactic that some providers have used to increase their Medicare reimbursement for specific medical conditions. This is accomplished by coding a provided service as a more expensive service than what was performed. With the proliferation of upcoding, there has been an unprecedented $12.5 billion in fraudulent Medicare charges. While solving the problem of upcoding will not eliminate the multiple contributing factors to this enormous healthcare expenditure, it would be a start.

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A recording of this event may be viewed at https://ensemble.marshall.edu/Watch/Hz3i2MSg

Copyright © 2018 The Author. All rights reserved.

Citation Information
Alberto Coustasse, Katrina Cremeans, Carli Followay and Jessica Oldaker. "Implications of Upcoding on Medicare Fraud" (2018)
Available at: http://works.bepress.com/alberto_coustasse/131/