A recent settlement was reached for Sutter Health care: "The settlement announced today resolves allegations that Sutter and its affiliates submitted unsupported diagnosis codes for certain patient encounters of beneficiaries under their care. These unsupported diagnosis scores inflated the risk scores of these beneficiaries, resulting in the MAO plans being overpaid." (quote from link below)

The detail of what ‘unsupported’ means is unclear in these two links describing the settlement, so it is difficult to draw conclusions. I wondered if AAPC has insight on the particulars.