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Kirk Nahra Weighs In on $900 Million Health Care Fraud Sweep

Healthcare Info Security
June 23, 2016

Kirk J. Nahra, chair of Wiley Rein’s Privacy Practice and co-chair of the Health Care Practice, was quoted in a Healthcare Info Security article about an unprecedented, nationwide health care fraud sweep led by the Medicare Fraud Strike Force. The U.S. Department of Justice and the U.S. Department of Health and Human Services announced June 22 that charges were filed against 301 individuals for $900 million in false Medicare and Medicaid billings.  

While the sweep was reportedly the largest health care fraud takedown in history, the article points out that it represents only a dent in addressing the larger health care billing problem. “Medicare/Medicaid fraud has been a big issue for a long time, and while the government keeps going after it—and generally is pretty good at it—it never goes away,” said Mr. Nahra.

“There is always lots to investigate and always tensions between paying claims and paying them quickly—where there is pressure to do so by government regulations and insurance regulation—while at the same time also doing a good job of policing fraud,” Mr. Nahra said. “So, [there are] lots of challenges, with the ‘bad guys’ being able to act faster and more creatively on a general basis.”

To read the complete article, please click here.