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April 8, 2021

Explain the implications of fraud and abuse for this case.

Propose an action plan outlining what the Healthcare Financing Administration (HCFA) should do to monitor DRG upcoding.

Recommend key elements to be included in a payment error prevention program.

Explain the implications of fraud and abuse for this case. Then, discuss the broader implications of fraud and abuse. What are the consequences, and who is impacted?

Case study

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