Upcoding and misrepresenting clinical information constitute fraud, cost a lot, and can result in patient harm and unnecessary procedures and prescriptions.
AMA J Ethics. 2020;22(3):E221-231. doi:
10.1001/amajethics.2020.221.
Physicians are cautioned that the two obstacles to reforming post-marketing clinical trials are the FDA's reluctance to revisit past approvals and its inability to enforce pharmaceutical companies' commitment to conduct Phase IV trials.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.