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Kirk Nahra Discusses FCA Applicability to Health Insurance Exchange Payments

Bloomberg BNA’s Health Law Reporter
February 8, 2013

Kirk J. Nahra, co-chair of Wiley Rein’s Health Care Practice, was quoted in a February 7 Bloomberg BNA article about a provision in the Affordable Care Act that subjects health insurance exchange payments to the False Claims Act (FCA).

The insurance exchanges required under the 2010 health care law are state-based marketplaces that will enable individuals to comparison-shop for coverage, starting next year. Applying FCA rules to payments made through those exchanges could lead to an increase in false claims cases, Mr. Nahra said.

“While the FCA is already enormously broad, and it is often hard to see how it can be broadened, any expansion of FCA’s reach simply gives the federal government more leverage and more flexibility in bringing its cases, which adds to the substantial imbalance of power in favor of the government in many False Claims Act cases,” Mr. Nahra told Bloomberg BNA.