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That makes sense, but again the ACA has provisions with massive fines ($50k+ per instance) for overbilling and a well-funded team of auditors to look for transgressions.

    If anyone is interested, go read the O'Reily book
    "Hacking Healthcare" to learn about how brainfucked
    the system is.
Thanks for the rec, it's been in my Kindle queue for awhile now, I'll make a point to actually read it soon.



  $50k+ per instance
No problem; $80,000 per spinal fusion. Even if caught, they're profiting. If.


    No problem; $80,000 per spinal fusion.
    Even if caught, they're profiting. If.
Cute, but the actual text in the law provides for penalties of either $50k or 3x the cost of the overbilled procedure. It also has provisions to bar them from ever submitting another claim to a Federal agency. So criminally overbilling for $80k could cost you $240k and your ability to practice medicine.




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