Robert W. Liles, J.D., M.B.A., M.S.

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.
• 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.
• Directed the internal audit of non-profit corporate operations, policies and procedures to better ensure statutory and regulatory compliance.
• Conducted internal investigation of alleged malfeasance of corporate employees. Provided recommendations for the implementation of safeguards to better prevent improper employee conduct.
• Worked with corporate clients to properly incorporate privacy provisions into the client’s overall effective compliance strategy.
• 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.
• Represented individuals and entities in ongoing litigation under the False Claims Act, addressing concerns raised by DOJ and State prosecutors.
• 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.