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Patricia O'Connell
Senior Communications Manager

Kirk Nahra Discusses Health Care Legal Trends to Expect in 2016

Bloomberg BNA’s Health Care Fraud Report, Daily Report for Executives
January 19, 2016

Kirk J. Nahra, chair of Wiley Rein’s Privacy Practice and co-chair of the Health Care Practice, was quoted in two recent Bloomberg BNA publications—Health Care Fraud Report (January 11) and Daily Report for Executives (January 14)—discussing legal trends to expect in 2016 for the health care industry. According to the articles, there is an expected increase in False Claims Act cases, especially those alleging a Stark law violation, and an expected increase in enforcement actions against corporate executives.

According to Bloomberg BNA, the Stark rule revisions in the Medicare physician fee schedule included several provisions intended to simplify provider compliance, including allowing an arrangement that qualifies for a Stark exception to continue indefinitely after its expiration date and allowing for the sharing of office space presuming the arrangement is in writing and is between a hospital and a physician. Mr. Nahra said he has seen a growing focus on Stark and anti-kickback issues because the rules are complex. “These rules are affecting normal and unproblematic business transactions because of uncertainty, even where there clearly is no real fraud risk,” he said. “The fraud folks could take a lesson from some of the privacy enforcement agencies where there is a much better sense of how to address sincere compliance efforts and unimportant errors rather than real compliance problems,” he added.

In the area of executive liability, Mr. Nahra said that the government is likely to continue exerting enforcement pressure on individuals in 2016, which will create tension between companies and their executives. “I think DOJ will be looking for ways to pursue actions against individuals that are not always criminal—meaningful fines, exclusions, etc., rather than full-out prosecutions,” he concluded.

To read the Daily Report for Executives article, please click here.