Health Care

For more information please see www.medicareaudits.com

Liles Parker attorneys have the litigation skills, health care regulatory understanding, and counseling skills necessary to efficiently resolve health care issues before they become a problem. Our attorneys regularly represent CMHCs, physicians, clinics, home health companies, nursing homes, assisted living facilities, intermediate care facilities, durable equipment suppliers, and practice management companies in Federal and State civil and criminal investigations and prosecutions. Robert W. Liles has held several significant positions in the Department of Justice (including serving as the first National Health Care Fraud Coordinator for the Executive Office for U.S. Attorneys) and is highly experienced handling health care fraud and Medicare overpayment / extrapolation cases.

Areas of Focus in Health Care Include:

Litigation Matters

• Representing providers in ZPIC, PSC and RAC audits.
• Representing CMHCs in Partial Hospitalization Program (PHP) billing disputes and overpayment audits.
• Litigating the statistical extrapolation of damages, seeking to have the extrapolation invalidated.  For additional information, see www.extrapolation.pro
• Handling redetermination, reconsideration and ALJ appeals in extrapolated Medicare damages cases.
• Responding to law enforcement investigations (Federal and State).
• Representing providers in connection with Grand Jury subpoenas and investigations.
• Responding to HHS-OIG and DOJ subpoenas and investigations on behalf of health care providers.
• False Claims Act – Qui Tam litigation.
• Representing Nursing Home/Long Term Care facilities in 0verpayment and billing disputes.
• Handling Stark self-referral questions and issues.
• Representing health care providers in connection with Anti-Kickback Act allegations and cases.

Regulatory & Transactional Matters

• Medicare conditions of participation, billing, and payment.
• Reimbursement issues.
• State licensure issues.
• Accreditation and certification.
• HIPAA privacy — confidentiality of medical records.
• Fee-splitting issues.

Counseling

• Designing and implementing regulatory compliance programs.
• Counseling health care organizations, their officers and directors in connection with government enforcement measures.
• Legislative and administrative health care lobbying.
• Legal issues arising from our clients’ business activities.
• General corporate representation.