Restraining Medicare Abuse: The Case of Upcoding

Many believe that some hospitals engage in upcoding, an act in which hospitals classify patients into a diagnosis related group (DRG) that yields higher reimbursement from Medicare than the DRG that is justified by patients’ medical records. For example, hospitals are reimbursed more than twice as much for DRG 79 (respiratory infections

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	Allen, Arthur C Associate Professor of Accountancy Expertise: Financial Accounting Governmental and Nonprofit Accounting Accountancy CBA 388 P.O. Box 880488 University of Nebraska-Lincoln Lincoln, NE 68588-0488, USA Phone: (402) 472-3275 Fax: (402) 472-4100 aallen1@unl.edu	Allen, Arthur C	Accountancy
	Ruchala, Linda V Associate Professor of Accountancy Expertise: Accounting Information Systems Cost Management Accountancy CBA 380 P.O. Box 880488 University of Nebraska-Lincoln Lincoln, NE 68588-0488, USA Phone: (402) 472-8812 Fax: (402) 472-4100 lruchala1@unl.edu	Ruchala, Linda V	Accountancy