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Kirk Nahra Discusses CMS Moratoria on Medicare Provider Enrollments

Bloomberg BNA Health Care Daily Report
February 9, 2016

Kirk J. Nahra, chair of Wiley Rein’s Privacy Practice and co-chair of the Health Care Practice, was quoted in a February 3 Bloomberg BNA article discussing the recent extension by the Centers for Medicare & Medicaid Services (CMS) of a freeze on new Medicare provider enrollments in several states. According to the article, this may point to an aggressive fraud-fighting strategy; however, experts say it could also reduce market competition and have little impact on criminal behavior.

Mr. Nahra said that the temporary moratoria authority may be a good example of a proactive approach to fraud prevention, but it also has some complicated implications for the overall health-care delivery system. “It’s essentially saying, ‘we’ve got a big fraud problem, and no one can come into this market until we figure out how to fix it,’” he said.

Mr. Nahra added that the moratoria authority is also unusual because it applies to an entire industry, rather than a specific individual, which raises some practical concerns over how long the CMS can keep extending it and blocking new entrants to the market. 

To read the complete article, please click here.