Vigorous coding is just as legal as paying as little taxes as allowed by the tax code. People are paid to make sure everything done strictly follows the letter of the law, with every t crossed and every i dotted.

OTOH, fraud is easy to catch - if the case repartition suddenly changes, or of there are some mistakes, something must be happening.

But the present incentives are for making rock solid, court-proof claim cases.

It induces all kind of interesting changes- like making sure 5 different health professionals all considered the patient was in end-of-life to qualify for a more lucrative palliative care.

As long as there are the 5 signatures on the paper (and in a 2nd line of defence, proof they saw the patient - like signatures, agendas, etc) it's as good as printing money.

One would have to be really really dumb or overtly greedy to engage in fraud.