Tag: upcoding
Dr. Oz would seek to modernize MA
March 19, 2025Liz Beaulieu, Editor
WASHINGTON – While he’s on record as a big supporter of Medicare Advantage, Dr. Mehmet Oz told the Senate Finance Committee during a confirmation hearing on Friday that, if confirmed as CMS administrator, he would reform prior authorizations, which he called “a pox on the system.”
Oz told the committee that he would push for reducing the some 15,000 procedures and medications that require prior auths to 1,000. He also said he would push for speeding up approvals.
“If...
Medicare pays out billions for 'upcoding'
September 18, 2012HME News Staff
WASHINGTON - Doctors and other medical professionals have added $11 billion or more to fees for Medicare beneficiaries over the last decade through “upcoding,” according to a new report from the Center for Public Integrity. Upcoding is the practice of charging for more costly services than are actually delivered. The report found that, between 2001 and 2010, doctors billed Medicare for longer, more complex office visits despite there being little hard evidence that patients required more...