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August 16, 2023

Illegal Billing Practices

General Questions

Reimbursement procedures are complex and detailed, especially those associated with government programs such as Medicare. Part of the regulatory requirements of Medicare is to prevent illegal billing practices such as churning, upcoding, and unbundling. For the Week 4 discussion, address the following, keeping in mind the above information:

Review the latest enforcement actions on this website. Identify a case where at least one of the following illegal actions was used—churning, upcoding, and unbundling.
What are some of the specific examples of actions taken against providers engaged in these practices?
To support your work, refer to the readings and relevant outside research. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

I have chosen a Former Emergency Department Nurse Sentenced to 3 Years After Stealing Pain Medication and Injecting Patients with Saline

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