Keqin Wei

Documents & Publications

Title Date
Upcoding in Medicare Advantage Among Dual Medicare-Medicaid Enrollees

Medicare Advantage (MA) plans report relatively more diagnoses per enrollee compared with those for similar fee-for-service enrollees, resulting in greater capitation payments. This practice, known as “upcoding,” results in excess government spending. Dual Medicare-Medicaid enrollees have increasingly enrolled in MA plans, some of which are targeted to duals. That duals…