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.
Streamlining US health care business has raised unique privacy concerns. Bills and explanations of benefits contain protected health information that could be disclosed to someone other than the patient.
AMA J Ethics. 2016;18(3):279-287. doi:
10.1001/journalofethics.2016.18.3.pfor4-1603.
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.