True or False: Upcoding has been a major focus of OIG's enforcement efforts, and HIPAA added another civil monetary penalty for upcoding violations.

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Upcoding refers to the practice of coding a diagnosis or service incorrectly to receive a higher reimbursement than what is warranted. This practice is a significant concern for the Office of Inspector General (OIG) as it can lead to fraud, waste, and abuse within healthcare systems, impacting the integrity of Medicare and Medicaid programs. The OIG places a strong emphasis on reducing upcoding through various enforcement efforts because of the financial implications and ethical considerations involved in accurate billing practices.

Additionally, the Health Insurance Portability and Accountability Act (HIPAA) introduced provisions that expanded the scope of civil monetary penalties related to healthcare fraud, including penalties for upcoding violations. This means that not only does upcoding violate ethical standards, but it also carries legal and financial consequences under HIPAA regulations. Thus, the assertion that upcoding has been a major focus of OIG’s enforcement efforts and that HIPAA has added a civil monetary penalty for such violations is accurate.

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