Jason Mehta Assesses Trump Administration Scrutiny of Medicare Advantage
Foley & Lardner LLP partner Jason Mehta assessed the potential enforcement approach of the Trump administration on Medicare Advantage plans in the Law360 article, “Medicare Advantage ‘Upcoding’ In Federal Crosshairs.”
“The government often follows where the money is going, and perhaps more importantly, whistleblowers also follow where the money is going,” Mehta commented, noting that Medicare Advantages plans “would be well-served by being extra cautious over the next few years.”
Mehta, co-chair of the Health Care Litigation team within the firm’s Health Care & Life Sciences Sector, continued that federal regulators expect Medicare Advantage plans and providers to conduct “their own prophylactic auditing” to prevent unnecessary coding.
“Increasingly, the government takes issue when providers do what is perceived as a one-way coding review — only looking to add codes, but not spending that corresponding amount of time looking to delete unnecessary codes,” Mehta explained.
“The wave of enforcement associated with Medicare Advantage has increased dramatically and exponentially,” Mehta added, “and I think it’s here to stay.”
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