Robert Liles

Robert W. Liles is Managing Partner at the law firm of Liles Parker in Washington, DC. Prior to entering practice, Mr. Liles was an Assistant U.S. Attorney in the Southern District of Texas. Mr. Liles' background is in health care administration. Prior to becoming a lawyer, Mr. Liles worked in various management positions in hospitals in San Antonio and Houston, Texas.

“Under the Fifth Amendment, You Have the Right to Remain Silent.” Well. . . Maybe Not.

Regulatory Issues | Privacy | Other /

(July 3, 2013):Everyone reading this article is likely familiar with the phrase “You have the right to remain silent.” In fact, a citizen’s right to remain silent is considered the cornerstone of an individual’s Fifth Amendment right against self-incrimination. As you may recall, the Fifth Amendment to the Constitution provides: “No person shall be held […]

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Strategic Health Solutions is Merely the Latest CMS Contractor to Flex its Audit Muscles

Medicare, Medicaid & Private Payor Updates /

(May 9, 2013): Strategic Health Solutions is an Omaha, Nebraska-based company that provides professional health care education and audit services for both federal and state government agencies. In recent months, a wide range of physicians (working in specialty areas ranging from endocrinology to pain management) have received audit letters asking for supporting documentation associated with

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Recovery Audit Contractor Changes will be Major in 2014

Medicare, Medicaid & Private Payor Updates /

(May 7, 2013): The Recovery Audit Contractor (RAC) program is slated to undergo significant changes in 2014. As discussed below, non-hospital health care providers and suppliers are likely to find the Medicare appeals process more complex than ever as RACs enter into the process in an effort to defend their denial decisions. I. Background of

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Does One of Your Employees Suffer from a Chronic Illness or Medical Condition? Consider the ADA When Assessing Their Request for Additional Medical Leave

Medicare, Medicaid & Private Payor Updates /

(March 19, 2013): It’s a fact of life – essentially all us will likely fall ill or develop a chronic medical condition at some point during our employment. Employees working in physician offices, home health agencies and for Durable Medical Equipment (DME) suppliers are no exception. When this occurs, owners and managers cannot forget their

Does One of Your Employees Suffer from a Chronic Illness or Medical Condition? Consider the ADA When Assessing Their Request for Additional Medical Leave Read More »

Record FCA Recoveries Were Collected by the Government in 2012

Regulatory Issues | Privacy | Other /

(February 12, 2013): The civil False Claims Act is the primary civil enforcement tool used by the U.S. Department of Justice. As discussed below, the False Claims Act is an extraordinarily useful statute for government prosecutors, both in terms of ease of use and in terms of the damages which may be recovered by the

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A TMB Complaint is Serious Business — Don’t Take the Texas Medical Board Complaint Process Lightly

Medicare, Medicaid & Private Payor Updates /

(February 10, 2013): Texas physicians face a myriad of challenges each and every day. In an era when reimbursement rates are declining yet many expenses are continuing to rise, physicians are also seeing many of their services co-opted by physician assistants and nurse practitioners, thereby further increasing competitive pressures. Unfortunately, these challenges only represent the

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The Texas Medical Board Remains Busy Due to High Number of Complaints Filed in 2012

Medicare, Medicaid & Private Payor Updates /

(February 7, 2013): The Texas Medical Board (Medical Board) was quite busy in 2012. While the number of disciplinary action taken had dropped in some categories, it rose in others. In fact, the overall number of complaints filed with the Medical Board was the 2nd highest in the last decade. The Medical Board’s workload numbers

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Texas Licensing Boards Have Announced a Pain Clinic Takedown and Have Disciplined Multiple MDs and PAs

Medicare, Medicaid & Private Payor Updates /

(February 5, 2013): In late December 2012, the Texas Medical Board and the Texas Physician Assistant Board announced that they had suspended or restricted the licenses of seventeen physicians and four physician assistants as part of coordinated “Pain Clinic Takedown.” These licensing Boards met over a two-week period in back-to-back disciplinary hearings last December and

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DME Claims Audits of Back Braces by OIG, MACs, and ZPICs are Likely to Further Intensify

Medicare, Medicaid & Private Payor Updates /

(February 5, 2013): A “back orthosis” is type of brace that is placed on the outside of a patient’s body and is intended to help stabilize a patient’s spine. In some instances, it is used to limit motion. In others, it is used to address a structural deformity which may exist (such as scoliosis). There

DME Claims Audits of Back Braces by OIG, MACs, and ZPICs are Likely to Further Intensify Read More »

Home Health Prepayment Reviews are Increasing. Is Your Documentation Compliant?

Home Health & Hospice /

(January 30, 2013): Are the home health services you are currently providing compliant with applicable coverage, documentation and medical necessity requirements? Have you carefully reviewed your current caseload to ensure that each patient does, in fact, qualify as “homebound.” Do you have an effective Compliance Plan in place to assist you with your efforts? Now,

Home Health Prepayment Reviews are Increasing. Is Your Documentation Compliant? Read More »