Jason Silberberg Quoted in Modern Healthcare: “More MA Insurer Audits Mean More Scrutiny on Providers”

Frier Levitt Partner Jason N. Silberberg was quoted in a Modern Healthcare article, “More MA Insurer Audits Mean More Scrutiny on Providers” by Lauren Berryman.

The Final Rule set to be implemented on February 1, 2023 is likely to increase the frequency and scope of RADV audits of Medicare Advantage Organizations (“MAOs”), which, in turn, could result in increased scrutiny by MAOs of downstream capitated providers’ and physician enablement companies’ Dx coding practices.

“Medicare Advantage organizations are going to do whatever they can to try and offset the major losses they’re going to take onto the providers,” Jason said. “One way I could perceive that happening is them effectively pushing the fraud narrative on the providers.”

Read article here.

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