Law360 Healthcare Authority, Medicare Advantage ‘Upcoding’ In Federal Crosshairs, quotes Henry Norwood, Esq., 4-15-25

Kaufman Dolowich’s Henry Norwood weighs in on the ‘upcoding’ issues tied to Medicare Advantage plans in a Law360 Healthcare Authority article on whether the plans will be under even greater scrutiny. The article explains that ‘upcoding’ is where privately run health plans may make patients appear sicker than they are to boost federal reimbursements. 

Mr. Norwood in the Law360 Healthcare Authority article noted that the plans have in recent years been the focus of heavy attention, but the problems aren’t new. He pointed to diabetes and depression as areas particularly prone to upcoding. He notes in the article, “in reality the MA upcoding problem has existed for decades despite prior efforts to solve a systematic issue.” 

Subscribers can read the full article here.