Robert W. Liles has worked in regulatory compliance as a Federal prosecutor and as defense counsel, for more than 25 years. This has provided a unique perspective on the challenges faced by clients in highly regulated industries such as health care, banking and finance. Mr. Liles focuses his practice on fraud defense, internal audits, investigations, compliance and regulatory matters. He has represented both individuals and entities in administrative, civil and criminal proceedings.
Robert W. Liles - Practice Concentration and Experience:
Mr. Liles first began working in hospital management after receiving both an M.B.A. and an M.S. in Health Care Administration. After graduating from law school, he was hired as an Assistant United States Attorney (AUSA) in the Southern District of Texas (SDTX) where he primarily handled False Claims Act cases. He was later promoted to Chief, Financial Litigation Unit.
Shortly after the passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Mr. Liles was asked to serve as our country's first National Health Care Fraud Coordinator.He was detailed to Washington, DC and was later promoted to the position of Deputy Director, Legal Programs, for the Executive Office for U.S. Attorneys (EOUSA), a component of the United States Department of Justice (DOJ). While at EOUSA, he advised Federal prosecutors around the country on civil and criminal fraud statutes, schemes, investigative tools, privacy concerns, and compliance issues. He was instrumental in writing and implementing DOJ guidance on the judicious use of the False Claims Act. Notably, while a Federal prosecutor, he was asked by the Office of Inspector General (OIG) to travel overseas and train Ukrainian prosecutors and investigators on health care fraud and abuse issues. Mr. Liles also regularly taught OIG agents and investigators at the Federal Law Enforcement Training Center (FLETC), on Jekyll Island.
Robert's health care management education / background and his prior experience as a Federal prosecutor provide a real-world perspective when advising individuals and entities on enforcement and regulatory compliance issues.
Financial / Regulatory Matters Handled:
- Managed our team in an investigation and document production responding to a subpoena directed to a large, international bank, by the Department of Treasury, Office of Foreign Asset Control (OFAC).
- Managed our production team's efforts in responding to a subpoena for documents by the Securities and Exchange Commission (SEC) that was directed to our client, a U.S. bank.
- Represented bank officer and defended his deposition by the Office of the Comptroller of the Currency (OCC).
- Represented large international bank in a False Claims Act case.
Health Care Regulatory Matters Handled:
- Represented multiple health care providers in Medicare revocation cases where CMS had revoked the provider's billing privileges.
- Represented licensed health care professionals in State Licensing Board proceedings.
- Represented multiple entities in connection with UPIC and ZPIC audits, and investigations by OIG.
- Worked with a variety of providers and suppliers to develop and implement an effective Compliance Plan. Conducted training for staff on statutory and regulatory requirements to be followed.
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Reviewed and challenged the validity of the statistical methodology used to extrapolate alleged damages in audit cases of Medicare, Medicaid and private payor medical, home health, DME and dental claims.
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Directed the internal audit of non-profit corporate operations, policies and procedures to better ensure statutory and regulatory compliance.
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Conducted internal investigation of alleged malfeasance of corporate employees. Provided recommendations for the implementation of safeguards to better prevent improper employee conduct.
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Worked with corporate clients to properly incorporate privacy provisions into the client’s overall effective compliance strategy.
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Provided assessment and advice to corporate clients on proposed business models, addressing both the prohibition against improper self-referrals, Federal and State Anti-Kickback Act concerns, and violations of False Claims Act provisions.
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Represented individuals and entities in ongoing litigation under the False Claims Act, addressing concerns raised by DOJ and State prosecutors.
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Managed large document productions on behalf of corporate clients in response to Grand Jury, DOJ and Federal agency subpoenas. Advised investors and investment companies with respect to health care sector issues and the possible impact of health care fraud enforcement activities.
- Served as Independent Review Organization (IRO) in connection with multiple Corporate Integrity Agreements (CIAs) between the OIG and Medicare providers.
Education:
- South Texas College of Law, Houston, Texas (J.D.)
- Trinity University, San Antonio, Texas (M.S. in Health Care Administration)
- Trinity University, San Antonio, Texas (Master's in Business Administration)
- University of the South, Sewanee, Tennessee (B.A. in Economics)
Certifications:
Professional Affiliations:
- Member, American Health Lawyers Association
- Member, National Association of Criminal Defense Lawyers
- Member, American Association of Professional Coders
- Member, National Alliance of Medical Auditing Specialists
- Member, American College of Legal Medicine
- Member, Christian Trial Lawyers Association
- Compliance Counsel, American Medical Billing Association
- Compliance Counsel, American Association of Clinical Endocrinologists
- Faculty Instructor, Practice Management Institute
Recent Awards:
- Top Attorneys -- Washington, DC (as published in the "Washington Lawyer")(May 2020).
- Rated "AV Preeminent" Highest Possible Peer Review Rating in Legal Ability and Ethical Standards (2003 -- 2021).
- Rated "10.0," AVVO's Highest Rating for Attorneys. (2021)
- America's Most Honored Professionals: Top 1% (2017-2020).
- Top Rated Lawyers in Washington, DC & Baltimore (as Published in the Wall Street Journal -- Based on Martindale-Hubbell Ratings)(December 2015).
Federal Admissions:
- U.S. Supreme Court
- District of Columbia District Court
- Maryland District Court
- Texas Northern District Court
- Texas Southern District/Bankruptcy Court
- Texas Western District Court
State Admissions:
- District of Columbia
- State of Texas
Presentations and Speaking Engagements (Partial Listing):
Upcoming Webinars - 2024
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Wednesday, November 6, 20241 p.m. EST / Noon CST / 10:00 a.m. PSTDuration: 60 Minutes
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Tuesday, November 26, 20241 p.m. EST / Noon CST / 10:00 a.m. PSTDuration: 60 Minutes
2024
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August 13, 2024
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March 26, 2024
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February 13, 2024
2023
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November 28, 2023
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November 1, 2023
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August 8, 2023
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April 25, 2023
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February 14, 2023
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January 31, 2023
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January 10, 2023
2022
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August 9, 2022
National Webinar,
American Medical Billing Association (AMBA) -
July 6, 2022
National Webinar,
Texas Association for Home Care and Hospice (TAHCH) -
June 1, 2022
National Webinar,
Texas Association for Home Care and Hospice (TAHCH) -
March 8, 2022
National Webinar,
American Medical Billing Association (AMBA) -
Healthcon 2022,
American Association of Professional Coders -
National Conference,
American College of Legal Medicine
2021
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May 5, 2021
National Webinar,
Texas Association for Home Care and Hospice (TAHCH) -
71st Annual Fall Convention & Trade Show,
Texas Health Care Association -
National Conference,
American Medical Billing Association,
Las Vegas, NV -
National Webinar,
Practice Management Institute (PMI) -
National Webinar,
National Alliance for Recovery Residences (NARR) -
National Webinar,
National Alliance of Medical Auditing Specialists (NAMAS). -
National Webinar,
Texas Association for Home Care and Hospice (TAHCH) -
National Webinar,
American Medical Billing Association (AMBA) -
National Webinar,
American Medical Billing Association -
National Webinar,
National Alliance of Medical Auditing Specialists (NAMAS) -
National Webinar,
Practice Management Institute (PMI) -
National Webinar,
Texas Association for Home Care and Hospice (TAHCH) -
National Podcast,
Doctor’s Management -
National Webinar,
Kentucky Association of Hospice and Palliative Care (KAHPC) -
National Webinar,
SideCar -
National Webinar,
American Medical Billing Association (AMBA)
2020
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August 5, 2020
National Webinar,
Texas Association of Home Care and Hospice (TAHCH) -
March 4, 2020
National Webinar,
Texas Association of Home Care and Hospice (TAHCH) -
National Webinar,
American Medical Billing Association (AMBA) -
Practice Management Institute,
Abilene TX -
National Webinar,
National Alliance of Medical Auditing Specialists (NAMAS) -
National Webinar,
National Alliance of Medical Auditing Specialists (NAMAS)
2019
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August 19, 2019
National Webinar, American Association of Clinical Endocrinologists -
G2: Lab Reimbursement Summit 2019,
Charlotte, NC -
Florida Behavioral Health Conference,
Orlando, FL -
West Coast Symposium on Addictive Disorders (WCSAD),
La Quita, CA -
Annual Conference -- American Alliance of Orthopedic Executives (AAOE),
Nashville, TN -
Annual Conference, American Association of Professional Coders (AAPC),
Las Vegas, NV -
National Webinar,
Liles Parker -
DHR Health -- Partnership Meeting,
Edinburg, TX -
National Webinar,
Exclusion Screening -
National Webinar,
American Medical Billing Association (AMBA) -
Endocrine University: American Association of Clinical Endocrinologists (AACE),
Mayo Clinic,
Rochester, MN -
American College of Legal Medicine,
11th Annual Ethical and Legal Aspects of Dentistry,
Los Angeles, CA -
National Webinar,
Exclusion Screening -
National Webinar,
National Alliance of Medical Auditing Specialists (NAMAS) -
American Association of Orthopedic Executives (AAOE),
Arlington, VA
2018
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September 27, 2018
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August 1, 2018
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July 12, 2018
2017
2016
2015
2014
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National Webinar Series,
American Medical Billing Association (AMBA)
2013
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National Conference,
Practice Management Institute,
New Orleans, LA
2012
2011
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2011
Revenue Cycle Management 2011,
Decision Health,
Atlanta GA -
2011
Annual Conference,
Practice Management Institute,
San Antonio, TX -
2011
National Webinar Series,
Practice Management Institute -
2011
National Webinar Series,
American Medical Billing Association -
2011
National Webinar Series,
Decision Health -
2011
Medical Coding,
Billing and National Conference,
CodingCon,
Las Vegas, NV -
2011
Annual Conference,
American Medical Billing Association,
Las Vegas, NV -
2011
Practice Management Institute,
Dallas, TX -
2011
Practice Management Institute,
Las Vegas, NV -
2011
Practice Management Institute,
San Diego, CA -
2011
Practice Management Institute,
Alexandria, VA
2010
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2010
National Webinar Series,
American Medical Billing Association -
2010
South Texas Home Health Conference,
The Forum,
McAllen, TX -
2010
Annual Conference,
Practice Management Institute,
San Antonio, TX -
2010
Annual Conference,
Practice Management Institute,
San Antonio, TX
2009
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2009
Webinar, Rocky Mountain Chapter,
American Medical Billing Association -
2009
Annual Convention,
Practice Management Institute,
Las Vegas, NV -
2009
9th Annual AMBA National Conference,
Las Vegas, NV -
2009
21st Annual PAHCOM Conference,
Phoenix, AZ -
2009
National Conference,
Practice Management Institute,
San Antonio, TX -
2009
Medical Billing and User Conference,
CodingCon,
Orlando, FL
2008
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2008
National Conference,
Practice Management Institute,
Las Vegas, NV -
2008
Regional Conference,
Practice Management Institute,
Anaheim, CA -
2008
Regional Conference,
Decision Health,
Atlanta, GA -
2008
Regional Conference, Decision Health, Atlanta GA -
2008
Fall Health Care Conference,
Practice Management Institute,
San Antonio, TX -
2008
Central Illinois Chapter Meeting,
American Medical Billing Association,
Chicago, IL -
2008
National Conference,
American Medical Billing Association,
Las Vegas, NV
2007
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2007
Semmelweis Annual Conference,
Washington, DC -
2007
Annual Convention,
Medical Association of Billers,
Las Vegas, NV -
2007
Chapter Conference for Medical Office Professionals,
American Medical Billing Association,
Largo, MD
2006
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2006
Semmelweis Society Annual Conference,
Washington, DC -
2006
Prosecuting Chiropractic Fraud Cases,
NCHAA,
Harrisburg, PA -
2006
Health Care Fraud Issues Faced by Medical Group Managers,
MGMA,
Washington, DC -
2006
Annual Conference,
American Medical Billing Association,
Las Vegas, NV -
2006
Medical Practice Coding & Compliance Summit,
Practice Management Institute,
San Antonio, TX
2003
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2003
Intensive Session in Trial Advocacy Skills, National Institute of Trial Advocacy,
Washington DC -
2003
Health Privacy,
American Academy of Pediatric Dentistry -
2003
Webinar,
Ohio Hospital Association
2002
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2002
Intensive Session in Trial Advocacy Skills,
National Institute of Trial Advocacy,
Washington DC -
2002
Trinity University and the Greater San Antonio Hospital Council, San Antonio TX -
2002
Greater New York Chapter of the American Corporate Counsel Association,
New York, NY
2001
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2001
Member Teleconference,
Ohio Hospital Association -
2001
Health Care Fraud Enforcement Issues and Considerations,
Georgia Podiatric Association,
Atlanta, GA -
2001
Member Teleconference, Healthcare Financial Management Association -
2001
Annual Meeting: Legislative Update, Academy of Managed Care Pharmacies,
San Antonio, TX
2000
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2000
Ukrainian Prosecutors and Interior Ministry of Interior Law Enforcement Officials,
Sponsored by the Department of Health and Human Services,
Office of Inspector General,
Kharkov, Ukraine -
2000
Evaluator Team Leader Training,
Executive Office for U.S. Attorneys -
2000
ABA Health Care Fraud Conference
1999
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1999
Midwest Regional Nursing Home Fraud and Abuse Conference,
Chicago, IL -
1999
Basic Health Care Fraud Enforcement, Federal Law Enforcement Training Center (FLETC), Glynco GA -
1999
Advanced Health Care Fraud,
National Advocacy Center,
Executive Office for U.S. Attorneys,
Columbia, SC
1998
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1998
National Level Health Care Fraud Working Group,
Executive Office for U.S. Attorneys,
Columbia, SC -
1998
National Civil Chiefs Seminar,
National Advocacy Center,
Executive Office for U.S. Attorneys,
Columbia, SC -
1998
Basic Affirmative Civil Enforcement Seminar,
Executive Office for U.S. Attorneys,
Columbia, SC
1997
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1997
Texas Statewide Financial Litigation Conference, San Antonio TX -
1997
Basic Health Care Fraud Prosecution Team Training,
Executive Office for U.S. Attorneys,
Washington DC -
1997
Affirmative Civil Enforcement,
Executive Office for U.S. Attorneys,
Washington DC
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