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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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) -
2022
Healthcon 2022, American Association of Professional Coders -
2022
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) -
2021
71st Annual Fall Convention & Trade Show, Texas Health Care Association -
2021
National Webinar, National Alliance of Medical Auditing Specialists (NAMAS) -
2021
National Webinar, Practice Management Institute -
2021
National Webinar, Texas Association for Home Care and Hospice (TAHCH) -
2021
National Podcast, Doctor’s Management -
2021
National Conference, American Medical Billing Association, Las Vegas, NV -
2021
National Webinar, SideCar -
2021
National Webinar, American Medical Billing Association -
2021
National Webinar, Kentucky Association of Hospice and Palliative Care (KAHPC) -
2021
National Webinar, American Medical Billing Association (AMBA) -
2021
National Webinar, Practice Management Institute (PMI) -
2021
National Webinar, National Alliance for Recovery Residences (NARR) -
2021
National Webinar. National Alliance of Medical Auditing Specialists (NAMAS). -
2021
National Webinar. Texas Association for Home Care and Hospice (TAHCH) -
2021
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) -
2020
National Webinar, American Medical Billing Association (AMBA) -
March 4, 2020
National Webinar, Texas Association of Home Care and Hospice (TAHCH) -
2020
Practice Management Institute, Abilene TX -
2020
National Webinar, National Alliance of Medical Auditing Specialists (NAMAS) -
2020
National Webinar, National Alliance of Medical Auditing Specialists (NAMAS)
2019
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2019
G2: Lab Reimbursement Summit 2019, Charlotte, NC -
2019
American Association of Orthopedic Executives (AAOE), Arlington, VA -
2019
Florida Behavioral Health Conference, Orlando, FL -
August 19, 2019
National Webinar, American Association of Clinical Endocrinologists -
2019
West Coast Symposium on Addictive Disorders (WCSAD), La Quita, CA -
2019
Annual Conference -- American Alliance of Orthopedic Executives (AAOE), Nashville, TN -
2019
Annual Conference, American Association of Professional Coders (AAPC), Las Vegas, NV -
2019
National Webinar, Liles Parker -
2019
DHR Health -- Partnership Meeting, Edinburg, TX -
2019
National Webinar, Exclusion Screening -
2019
National Webinar, American Medical Billing Association (AMBA) -
2019
Endocrine University: American Association of Clinical Endocrinologists (AACE). Mayo Clinic, Rochester, MN -
2019
American College of Legal Medicine, 11th Annual Ethical and Legal Aspects of Dentistry, Los Angeles, CA -
2019
National Webinar. Exclusion Screening -
2019
National Webinar, National Alliance of Medical Auditing Specialists (NAMAS)
2018
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September 27, 2018
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2018
Annual Conference, Cape Cod Symposium on Addictive Disorders (CCSAD), Hyannis, MA -
2018
Annual Conference (AOA-36), Association of Otolaryngology Administrators, New Orleans, LA -
August 7, 2018
National Webinar, American College of Clinical Endocrinologists -
July 12, 2018
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August 1, 2018
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2018
AAPC Alexandria, VA Chapter Conference -
2018
Annual Conference, American College Health Association, Washington, DC -
2018
National Webinar, Exclusion Screening -
2018
Quality & Compliance Conference, Home Care Alliance of Massachusetts, Worchester, MA -
2018
Annual Retreat, Washington, DC -
2018
National Webinar, Exclusion Screening -
2018
Endocrine University, American Association of Clinical Endocrinologists, Rochester, MN -
2018
Annual Conference, American College of Legal Medicine, Charleston, SC
2017
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July 5, 2017
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Enforcement Efforts for 2018: What You Can Do to Prepare for the Upcoming Changes in Laws & Statutes2017
National Conference, National Alliance of Medical Auditing Specialists, Orlando, FL -
2017
Annual Conference (AOA-35) , Association of Otolaryngology Administrators, Las Vegas, NV -
2017
National Conference, National Alliance of Medical Auditing Specialists, Orlando FL -
2017
National Conference, American Medical Billing Association, Las Vegas, NV -
2017
National Conference, The Business of Pain Medicine -
2017
National Webinar, American Association of Healthcare Administrative Management -
2017
New Directions in Home Care & Hospice Conference, Dixon Healthcare Solutions, Las Vegas NV -
2017
National Webinar, American Medical Billing Association -
2017
National Webinar, Texas Association for Home Care and Hospice -
2017
Annual Conference, West Virginia State Medical Association, Charleston WV -
2017
Annual Conference, West Virginia State Medical Association, Charleston WV
2016
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2016
National Webinar, Texas Association for Home Care and Hospice -
2016
National Webinar, Texas Association for Home Care and Hospice -
2016
National Webinar, Texas Association for Home Care and Hospice -
2016
National Conference, Practice Management Institute, Las Vegas NV -
2016
National Conference, Practice Management Institute, Las Vegas NV -
2016
National Conference, National Alliance of Medical Auditing Specialists, Orlando FL -
2016
National Conference, National Alliance of Medical Auditing Specialists, Orlando FL -
2016
National Conference, National Alliance of Medical Auditing Specialists, Orlando FL -
2016
National Conference, National Alliance of Medical Auditing Specialists, Orlando FL -
2016
National Conference, American Medical Billing Association, Las Vegas NV -
2016
National Conference, Professional Association of Health Care Office Management (PAHCOM), Clearwater Beach FL -
2016
National Conference, American Medical Billing Association, Las Vegas NV -
2016
National Webinar, National Alliance of Medical Auditing Specialists -
2016
National Conference, Association of Otolaryngology Administrators, Chicago IL -
2016
National Conference, Association of Otolaryngology Administrators, Chicago IL -
2016
National Webinar, Texas Association for Home Care and Hospice -
2016
National Conference, Practice Management Institute, Las Vegas NV -
2016
National Webinar, Practice Management Institute -
2016
National Webinar, American Medical Billing Association (AMBA) -
2016
National Conference, Practice Management Institute, New Orleans LA -
2016
National Conference, Practice Management Institute, New Orleans LA -
2016
16th Annual Health Care Business Summit, MedAssets, Las Vegas NV -
2016
Long Term Care and the Law, American Health Lawyers Association, Orlando FL
2015
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2015
15th Annual National Medical Billing Conference, American Medical Billing Association, Las Vegas NV -
2015
Cutting Edge Home Health Leadership Summit, Dixon Healthcare Solutions, Maui HI -
2015
West Virginia State Medical Association -- Winter Conference, Charleston WV -
2015
Private Duty Conference, Dixon Healthcare Solutions, Las Vegas NV -
2015
National Conference, Practice Management Institute, San Antonio TX -
2015
National Webinar Series, Exclusion Screening -
2015
National Webinar Series, American Medical Billing Association -
2015
Home Health Conference, Dixon Healthcare Solutions, Las Vegas NV -
2015
Home Health Conference, Dixon Healthcare Solutions, Las Vegas NV -
2015
Doctor's at Renaissance Conference Center, Edinburg TX -
2015
APPNA, Arlington VA
2014
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2014
Private Duty Conference, Texas Association of Home Care and Hospice, San Antonio TX -
2014
Regulatory Educational Group Services, McAllen TX -
2014
NSCHBC Annual Conference – San Juan PR -
2014
NAMAS Annual Conference, Ashville NC -
2014
NAMAS Annual Conference, Ashville NC -
2014
Fall Conference -- Jefferson IPA, Dallas TX -
2014
National Webinar Series, Practice Management Institute -
2014
National Webinar Series, American Medical Billing Association
2013
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2013
Rio Grande Valley Healthcare Fraud and Compliance Conference, McAllen TX -
2013
Physician Practice Conference & Annual Business Meeting, West Virginia Medical Association, Charleston WV -
2013
National Conference, Practice Management Institute, New Orleans, LA
2012
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2012
National Webinar Series, American Medical Billing Association -
2012
National Webinar Series, American Medical Billing Association -
2012
Fifth Annual Medical Coding Conference, Coding Con, Orlando FL
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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