"Nationwide Healthcare Lawyers"
Senior Counsel Office: (202) 298-8750 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 / […]
Robert Saltaformaggio Read More »
(January 26, 2023): Since the inception of the pilot program in 2015, the Targeted Probe and Educate Audit (TPE audit) program has effectively been a double-edged sword for most providers. On the positive side, it has served as an educational tool that providers can use to better ensure that their medical necessity, documentation, coding and
TPE Audits: The Process & Expected Targets in 2023 Read More »
(October 3, 2022): Aquatic therapy is a common method of rehabilitation and maintenance for several types of injuries and conditions, and the practice is widely accepted by Medicare, Medicaid and many private payors. Historically, both payors and law enforcement have routinely audited aquatic therapy claims. The Centers for Medicare and Medicaid Services (CMS) initially suspended
Enforcement Efforts Targeting Aquatic Therapy Providers and CPT Code 97113 Claims Read More »
(September 20, 2022): In the Medicare billing context, the term “Incident To” refers to the fact that under certain circumstances, the services of non-physician, mid-level practitioners (such as Nurse Practitioners (NPs) and Physician Assistants (PAs)) are “. . . furnished as an integral, although incidental, part of the physician’s personal professional services in the course
(July 28, 2022): The business side of medicine has changed considerably over the last decade. Health care laws, regulations, and administrative policies are constantly evolving. A number of these changes have impacted health care practices, billing companies, and the third-party billing contracts executed between these parties. From its earliest beginnings, the majority of third-party billing
(May 12, 2022): Hospice agencies are again the focus of both state and federal investigators and prosecutors around the country. The number of hospice audits and investigations at both the state and federal levels have risen in 2022. This isn’t surprising given the ever-expanding level of beneficiary participation and cost of Medicare’s hospice benefit program.
State and Federal Hospice Audit and Investigation Efforts are Expanding in 2022 Read More »
(February 22, 2022): The treatment and business challenges presented by COVID-19 over the last two years have been especially demanding on dentists and their practices. Between the lockdowns and a hesitancy by many individuals to schedule non-emergent dental care, many dental practices have found it tougher than ever to maintain previous levels of profitability. Not
A Review of Dental Enforcement in 2021 and a Look at What Dentists Should Expect in 2022 Read More »
Robert W. Liles has worked in regulatory compliance as a Federal prosecutor and as defense counsel, for more than 25 years. This has provided a unique perspective on the challenges faced by clients in highly regulated industries such as health care, banking and finance. Mr. Liles focuses his practice on fraud defense, internal audits, investigations,
Robert W. Liles, J.D., M.B.A., M.S. Read More »
(January 13, 2021): Over the last few years, we have noted a significant increase in the number of audits initiated against Chiropractor owned multidisciplinary practices. Typically, these integrated medical practices and clinics employ at least one Chiropractor (typically in an ownership or managerial capacity), along with multiple Doctors of Medicine (MDs), Doctors of Osteopathy (DOs).
Chiropractor Owned Multidisciplinary Practices are at a Higher Risk of Audit Read More »
(Updated January 9, 2021): Owners of healthcare companies often wonder whether the government can pierce the corporate veil and try to hold the owners personally liable for overpayment claims when facing a program integrity audit by a Unified Program Integrity Contractor (UPIC). [1] This rarely happens, but assuming that a provider does not prevail in
Pierce the Corporate Veil — Are You Personally Liable for a UPIC Overpayment? Read More »
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