I don't think the billing system is malicious. But at the end of the day, each "provider" is given incentives to bill. They get promotions based on this. So the

I don't think the billing system is malicious. But at the end of the day, each "provider" is given incentives to bill. They get promotions based on this. So the maliciousness is a distributed system that does not get codified at all. It's the exact same thing as cops getting incentives for speeding tickets. Then you start getting more speeding tickets for 5 over instead of 10 over.