Benesch Partner Mark Silberman Quoted in Crain’s Chicago Business on AI-Driven Medicaid Audits and Provider Compliance Risks

Mark Silberman, Vice Chair of Benesch’s Healthcare Practice Group, was quoted in Crain’s Chicago Business article, “The feds’ AI fraud hunt alarms Medicaid providers.” The article examines a new federal effort to use AI to analyze Medicaid audits for fraud, as well as concerns that it could penalize healthcare providers for routine billing errors and create broader financial and operational risks.

Silberman noted that the primary concern with AI-driven audits is not just identifying intentional fraud, but the risk that repeated, minor billing errors could be flagged at scale, explaining, “In healthcare billing, you don’t make thousands of mistakes, you make one mistake, thousands of times.” He also underscored how exposed the industry is to repayment efforts, stating, “The unfortunate reality is healthcare is uniquely vulnerable to this kind of fund recovery.” While acknowledging that aggressive fraud enforcement is not new, Silberman cautioned that AI could significantly amplify its impact and increase pressure on Medicaid-reliant providers. He emphasized the importance of proactive compliance, advising, “It’s better to self-report problems in billing… than to leave them for regulators to call them fraud.”

More: HHS AI Medicaid audits raise fraud fears among providers – Crain’s Chicago Business