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.

Conducting a Gap Analysis / Mock Audit: An Essential Compliance Tool for Your Practice

Medicare, Medicaid & Private Payor Updates /

(November 15, 2011): Understandably, health care providers have grown weary of government audits, malpractice issues, peer reviews and private payor assessments. In an effort to reduce their potential liability, many providers are now regularly utilizing Gap Analyses / Mock Audits to test their preparedness for audit. In doing so, they have been able to identify […]

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Maryland Bullying, Cyber Bullying and Hazing Laws

Medicare, Medicaid & Private Payor Updates /

(October 25, 2011): As set out under Maryland law, “All students in Maryland’s public schools, without exception and regardless of race, ethnicity, region, religion, gender, sexual orientation, language, socioeconomic status, age, or disability, have the right to educational environments that are safe, appropriate for academic achievement, and free from any form of harassment.” I. Maryland

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Health Integrity Audits of Texas and Oklahoma Home Health Agencies are on the Rise.

Home Health & Hospice /

(August 14, 2011): Home health agencies in Texas and Oklahoma remain under considerable scrutiny by Medicare contractors tasked with identifying fraud and abuse perpetrated against the Medicare Trust Fund. As discussed below, these Medicare contractors have a number of tools at their disposal, many of which can effectively place a home health agency in financial

Health Integrity Audits of Texas and Oklahoma Home Health Agencies are on the Rise. Read More »

Ten Recommendations to Improve Medicare Compliance and Prepare for a ZPIC Audit

Medicare, Medicaid & Private Payor Updates /

(July 24, 2011): Has your Texas physician practice, home health agency, hospice, DME company or PT / OT / ST clinic been audited by a Zone Program Integrity Program (ZPIC)? If not, it may only be a matter of time. Despite your best efforts to follow Medicare’s directives, your organization may still be identified as

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The OIG Found that More than Half of All Power Wheelchair Claims Paid by Medicare were Improper.

Medicare, Medicaid & Private Payor Updates /

(July 16, 2011): As Zone Program Integrity Contractor (ZPIC) audits of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) companies continue to climb, the Department of Health and Human Services, Office of Inspector General (HHS-OIG), has now reported that more than one-half of the recent power wheelchair claims by Durable Medical Equipment (DME) suppliers were

The OIG Found that More than Half of All Power Wheelchair Claims Paid by Medicare were Improper. Read More »

ZPICs are Conducting SNF Medicare Audits Around the Country!

Medicare, Medicaid & Private Payor Updates /

(July 10, 2011): In response to a report released by the Office of the Inspector General (HHS-OIG) of the Department of Health and Human Services, the Centers for Medicare and Medicaid Services (CMS) recently signaled that it will direct Medicare contractors to more closely scrutinize the billing patterns of skilled nursing facilities (SNFs). In fact,

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Physician Alleged to Have Wrongfully Disclosed PHI is Being Prosecuted

Medicare, Medicaid & Private Payor Updates /

(June 24, 2011): Physicians and other health care providers should take care — wrongfully disclosed PHI (protected health information) and could land you in Federal prison. Earlier this week, Virginia osteopath was indicted in the Eastern District of Virginia on charges that he illegally disclosed a former patient’s health information to the patient’s employer. The

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Texas Physicians and the Texas Medical Board Under HB 680

Medicare, Medicaid & Private Payor Updates /

(June 21, 2011): Last week, Texas Governor Rick Perry signed legislation aimed at bringing modest reform to the rules governing investigations of physicians by the Texas Medical Board. The Texas Medical Board is the state’s regulatory body that licenses and disciplines physicians and other health care professionals. House Bill 680 — HB 680, which takes

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Lose Your Appeal at Reconsideration? Consider an ALJ Hearing

Medicare, Medicaid & Private Payor Updates /

(June 18, 2011): As a review of the last several quarters of Medicare appeals statistics reflects, an overwhelming percentage of Medicare providers appealing alleged overpayments through the Medicare administrative appeals process have chosen to “throw in the towel,” so to speak, when they have lost at the reconsideration level. As you will recall, at the

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New Face-to-Face Requirements for Hospices and Home Health Agencies

Home Health & Hospice /

(May 8, 2011): Over the last year, both hospice and home health agencies have faced a number of regulatory challenges, including but not limited to the face-to-face issue. In many instances (including the new requirement discussed below), these regulatory changes have been implemented in an effort to better ensure that the services ordered are reasonable

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