Robert W. Liles
Office: (202) 298-8750
Facsimile: (202) 337-5804
Robert Liles’ Practice Concentration and Experience:
Mr. Liles focuses his practice on fraud defense, internal audits / investigations and compliance and regulatory matters. Mr. Liles has represented a wide variety of health care providers administrative and civil proceedings and in connection with internal compliance reviews. He currently serves on the Advisory Panel for the Corporate Compliance Center for the South Texas College of Law. Mr. Liles has achieved an “AV” rating by Martindale-Hubbell, the highest rating that may be awarded to an attorney. He has also been rated “10.0” (out of a possible 10.0) by AVVO, a nationwide attorney rating service.
Robert first began working in health care management after receiving a Master’s Degree in Health Care Administration in 1984. He subsequently attended law school and was hired after graduation as an Assistant United States Attorney (AUSA) in the Southern District of Texas (SDTX). While an AUSA, Robert worked out of the Houston office and primarily handled False Claims Act matters and cases. He was later promoted to serve as Chief of the Financial Litigation Unit for the SDTX.
Shortly after the passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Robert was detailed to Washington, DC and was asked to serve as the first “National Health Care Fraud Coordinator” for the Executive Office for U.S. Attorneys (EOUSA), a component of the United States Department of Justice (DOJ). .In this capacity, he advised AUSAs around the country on civil and criminal health fraud statutes, schemes, investigative tools, privacy concerns, and compliance issues. He was instrumental in writing and implementing DOJ guidance on the judicious use of the False Claims Act. Robert was subsequently promoted and served as Deputy Director for Legal Programs at EOUSA. While with DOJ, Robert was recognized and given numerous awards by the agency for his efforts, one of which was a “Director’s Award,” the highest award that can be bestowed by EOUSA.
Since entering private practice, Robert has continued to build on his health care background and experience. He has represented physicians, health care providers, durable equipment suppliers and third-party billing companies around the country in a wide variety of regulatory, audit and compliance projects. He has also represented physicians and other licensed clinical professionals in State Medical Board actions. He has also represented health care providers in connection with government investigations, overpayment audits by Medicare contractors and reviews by Special Investigative Units (SIUs) working for private payor plans.
Robert is a nationally-recognized speaker and educator on health law regulatory issues. He has taught and lectured at more than 100 regional and national conferences, seminars and webinars to Federal and State prosecutors, investigators, auditors, industry representatives, providers and suppliers on a variety of regulatory issues. Notably, while a Federal prosecutor, Robert was asked by the Department of Health and Human Services, Office of Inspector General (HHS-OIG) to accompany several of their staff members overseas to train Ukrainian prosecutors and investigators on how to handle allegations of health care fraud and abuse. Robert also regularly taught HHS-OIG agents and investigators at the Federal Law Enforcement Training Center (FLETC), on Jekyll Island. Recent issues covered in training courses he has taught have included the current audit initiatives being pursued by Zone Program Integrity Contractors (ZPICs) and Recovery Audit Contractors (RACs), responding to adverse administrative actions, conducting a GAP analysis and developing an effective Compliance Plan.
Robert currently serves as outside General Counsel for the American Medical Billing Association and is recommended by numerous health care related associations to their members. Several years ago, Mr. Liles was asked by Practice Management Institute, one of the nation’s oldest health care administration educators, to develop the curriculum for a non-hospital program for Certified Medical Compliance Officers. This certification program has been widely lauded by participants and is believed to be the most comprehensive, targeted compliance certification program currently available to small and mid-sized health care provider organizations. The course was recently approved for physician Continuing Medical Education (CEU) credit.
Mr. Liles’ health care management education / background and his extensive experience working in the area of health law provide a real-world perspective when advising health care providers and durable medical equipment suppliers on enforcement and regulatory compliance issues.
Recent Matters Handled Include:
Worked with a variety of providers and suppliers to develop and implement an effective Compliance Plan. Conducted training for clinical and non-clinical staff on statutory and regulatory requirements to be followed.
- Represented providers and suppliers in connection with audits conducted by ZPICs, RACs, Medicaid Integrity Contractors (MICs) and Medicaid Fraud Control Units (MFCUs) around the country. Diligently worked to have statistical extrapolations of alleged damages dismissed. Trained providers and suppliers around the country on how to best respond when their practice, clinic, agency to organization has been subjected to a ZPIC and / or RAC audit.
- Advised a variety of specialty health care providers in the areas of home health, pain management, psychiatry, hospice, internal medicine, oncology, podiatry, ambulance services, cardiology, physical/occupational and speech therapy, physiatry, and durable medical equipment, in fraud, overpayment and compliance matters.
- Directed 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/State Anti-Kickback Act concerns, and violations of Federal/State False Claims Act provisions.
- Represented individual and corporate health care providers 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.
- South Texas College of Law, Houston, Texas (J.D., 1992)
- Trinity University, San Antonio, Texas (M.S. in Health Care Administration, 1985)
- Trinity University, San Antonio, Texas (Master’s in Business Administration, 1984)
- University of the South, Sewanee, Tennessee (B.S. in Economics, 1982)
- State Bar of Texas
- District of Columbia Bar
- Member, American Health Lawyers Association (AHLA)
- Member, Christian Trial Lawyers Association
- Member, Health Care Compliance Association (HCCA)
- Member, American Association of Professional Coders (AAPC)
- Advisory Counsel, South Texas College of Law Corporate Compliance Center
- U.S. Supreme Court
- District of Columbia District Court
- Maryland District Court
- Texas Northern District Court
- Texas Southern District/Bankruptcy Court
- Texas Western District Court
- District of Columbia
- State of Texas