Upcoding Allegations Settled

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A $1.25 million settlement resolves whistleblower allegations that emergency room Medicare patients were admitted for costly and medically unnecessary one- and two-day overnight hospital stays instead of treating them in less costly outpatient service or keeping them under observation. The hospitals also upcoded inpatient diagnoses (billed Medicare for more serious medical conditions than the patients actually had) to increase Medicare payments. Read a HealthLeaders news story and a Department of Justice press release.



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