Robert Saltaformaggio

Practice Concentration and Experience:

Robert Saltaformaggio is a Senior Counsel at Liles Parker and focuses on regulatory healthcare compliance matters, fraud and abuse, and reimbursement issues. He represents clients nationwide in connection with many health law matters, such as coverage disputes, documentation concerns, compliance, medical board complaints, and exclusion / termination issues. He has worked with broad mix of providers, including wound care specialists, home health companies, hospice agencies, substance abuse providers, mental health professionals, physical therapists, and primary, urgent, and specialty care practitioners.

Not only is Mr. Saltaformaggio a licensed attorney, but he is also a Certified Professional Coder. This expertise has allowed him to assist providers in assessing whether claims meet applicable Medicare, Medicaid or other public payor coverage and payment requirements. Mr. Saltaformaggio also handles claims disputes with major private payors, such as the various BlueCross BlueShield entities and UnitedHealthcare. He has extensive experience working on administrative appeals of large alleged extrapolated overpayments assessed by the Centers for Medicare and Medicaid Services’ (CMS) program integrity contractors -- primarily Unified Program Integrity Contractors (UPICs). For example, Robert resolved a six-figure alleged overpayment involving in favor of a wound care client at the ALJ level. He also resolved UPIC allegations concerning a five-figure overpayment for a urology client’s use of novel urine PCR testing. He also represents health care providers and suppliers in connection with Comprehensive Error Rate Testing (CERT) audits, Supplemental Medical Review Contractor (SMRC) reviews, and Medicare Administrative Contractor (MAC) "Targeted Probe and Educate" (TPE) reviews. Mr. Saltaformaggio recently helped a hospice agency client avoid a TPE Round 2 by successfully reducing the client’s error rate to the government’s satisfaction. He also has extensive experience representing health care providers in connection with audits and investigations on behalf of state Medicaid programs as well as private payor SIUs. Finally, Mr. Saltaformaggio has extensive experience representing providers in connection with state and federal fraud investigations.

Prior to rejoining Liles Parker, Robert helped lead Amazon.com’s compliance efforts for its state and local political engagement program. Robert also previously served as an Attorney Advisor with the US Department of Commerce’s Ethics Law and Programs Division. This time included a detail as an Ethics Attorney in the White House Counsel’s Office.