[oldalum]

 Some of them just stretch the rules (for example, up-coding diagnoses to get better reimbursement)

I think you're being too kind. Definition of fraud is: "wrongful or criminal deception intended to result in financial or personal gain. ""Upcoding" services or diagnoses means falsifying the service or diagnosis billed in exchange for more money. Which is particularly clear when false information is entered into the medical record to justify it. Just because it is done under the genteel banner of medicine doesn't prevent it from being fraud. (to be clear, I'm not talking about choosing between two legitimate codes or diagnoses and picking the higher-reimbursed one.)

[oldalum]

 Some of them just stretch the rules (for example, up-coding diagnoses to get better reimbursement)

I think you're being too kind. Definition of fraud is: "wrongful or criminal deception intended to result in financial or personal gain. ""Upcoding" services or diagnoses means falsifying the service or diagnosis billed in exchange for more money. Which is particularly clear when false information is entered into the medical record to justify it. Just because it is done under the genteel banner of medicine doesn't prevent it from being fraud. (to be clear, I'm not talking about choosing between two legitimate codes or diagnoses and picking the higher-reimbursed one.)