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.

HHS-OIG Finds ZPICs May Have Conflicts of Interest

(September 13, 2012): Many physicians and other health care providers around the country are reeling from post-payment and pre-payment assessments conducted by Zone Program Integrity Contractors (ZPICs). As ZPIC audits are being conducted, an issue has recently arisen regarding their independence. According to a recent report issued by the Office of Inspector General (OIG), the […]

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Texas Medical Privacy Act Takes Effect

(September 11, 2012): They say that “Everything is Bigger in Texas,” and its law concerning medical privacy is no exception. The Texas Legislature recently enacted the Texas Medical Privacy Act (TMPA)[1], also known as the Texas HIPAA law. The new law substantially increases the compliance burden on medical and service providers, suppliers, business associates, third

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What Should I Do If I Discover A Breach of PHI?

(September 6, 2012): What should you do if you discover a breach of PHI (Protected Health Information). The short answer is: it all depends on who you are. With the rise in concern over and enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), patients, families, practitioners, and health care executives need

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Options for Responding if Your Practice is Placed on ZPIC Prepayment Review

(September 3, 2012): Zone Program Integrity Contractors (ZPICs) have turned much of their attention to prepayment review, the process by which the Medicare contractor reviews a claim for problems before it is paid. Unlike postpayment review, ZPIC prepayment review does not have an administrative appeals process, making these types of reviews incredibly damaging for a

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Overseas Outsourced Billing and Coding – Compliance Risks

(August 16, 2012): Thinking of sending your medical coding and billing functions out of the country? You better think twice. While overseas outsourced billing is growing in popularity for medical office functions, this practice represents a unique and growing set of problems for both physician practices and 3rd party billers. And the news is just

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Medicare Administrative Appeals Process – An Overview for New Providers

(August 15, 2012): Is this your first time being audited by a Medicare Administrative Contractor (MAC) or a Zone Program Integrity Contractor (ZPIC)? If so, the brief outline below can provide a handy summary of the Medicare appeals process. I. Step 1 – Request for Information: In most instances, a health care provider will receive

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Healthcare Cloud Computing – Compliance Risks

(August 14, 2012): Cloud computing is in the process of revolutionizing the way that individuals and businesses store, receive, and use their data. You may have heard about it through companies such as Google, Apple, and Microsoft, all advertising sophisticated cloud computing services. But what are the risks your organization faces with respect to healthcare

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Liles Parker Webinars 2012 — Approved for Free AAPC CEUs

(August 6, 2012): The firm is proud to announce that our monthly Liles Parker webinars 2012 series, sponsored and hosted by our friends at the American Medical Billing Association (AMBA), has been approved for free AAPC CEUs by the professional coding organization. AAPC recently approved a series of 6 webinars covering legal and compliance issues

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There are Seven Compliance Plan Elements – Is Your Healthcare Company Compliant?

(August 2, 2012): Under the Affordable Care Act (ACA), which was recently upheld by the Supreme Court, the Secretary of the Department of Health and Human Services (currently Kathleen Sebelius) may require that all providers participating in federal health care programs implement an effective compliance plan. While regulations covering this issue have not yet been

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