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Patricia O'Connell
Senior Communications Manager

Kirk Nahra Quoted Extensively on Top 2014 Health Law Issues, Medicare Fraud Proposal

Bloomberg BNA’s Health Law Reporter
January 13, 2014

Kirk J. Nahra, chair of Wiley Rein’s Privacy Practice and co-chair of the Health Care Practice, was quoted extensively in a January 9 Bloomberg BNA article outlining this year’s top health regulatory issues.  The publication also quoted him in a story about Medicare antifraud efforts.

Mr. Nahra is a member of the advisory board for Bloomberg BNA’s Health Law Reporter.  Based on a vote by the board, the publication said health plan regulation will be the top health law issue in 2014.  The board members’ list of top issues also included Medicare reimbursement.

Although “it’s not clear that Medicare will face significant new legal or regulatory issues ... the entire environment surrounding Medicare will be challenged because of all the problems with the exchanges and related pressure that will be placed on the biggest government health-care programs,” Mr. Nahra said.  Health-care exchanges had been an “enormous challenge” for health plans even before “operational difficulties” arose, he said.

“Now, in addition to the added time and cost associated with all of the exchange problems, we see an increased likelihood that the benefits of the exchanges for the plans will likely be smaller and the challenges and costs greater,” he said.

Fraud and abuse remain another top concern, “because the ongoing difficulties of health-care reform will place enormous financial pressures on the federal government to recover funds and because the administration will face substantial challenges in finding the difficult balance between getting these programs up and running” and enforcing the rules,  Mr. Nahra said.

Weighing in on health information and technology, he said cloud computing’s impact on the industry is “substantial, and there will be real pressure to both expand use of the cloud and increase oversight and regulatory protections for cloud data.”

Use of electronic health records (EHRs) is also expanding, but “there are real challenges to linking EHRs through” health information exchanges, he said.  Mr. Nahra added that cybersecurity rules “are not yet final for the exchanges and few people seem to have confidence in the security arrangements.”

In the second Bloomberg BNA article, Mr. Nahra commented on a proposed rule that would strengthen efforts to collect Medicare overpayments from Medicare Advantage plans and Medicare Part D sponsors.  “The idea of overpayments in these programs is interesting in general, since the plans get paid in a very different way than health-care providers typically do, which is where the overpayments idea started,” Mr. Nahra said.

He said a failure to return overpayments would “create an obligation (following the reconciliation period), and the government could use a failure to return something as the basis itself for a case.”  But he added that that situation would be unlikely to arise very often.

The January 9 Bloomberg BNA articles quoting Mr. Nahra can be read here.