Robert Liles

Robert W. Liles is Managing Partner at the law firm of Liles Parker in Washington, DC. Prior to entering practice, Mr. Liles was an Assistant U.S. Attorney in the Southern District of Texas. Mr. Liles' background is in health care administration. Prior to becoming a lawyer, Mr. Liles worked in various management positions in hospitals in San Antonio and Houston, Texas.

Identity Theft — Red Flags Rule — Treating Doctors Like Banks Is Delayed Once Again

Compliance, Medicare, Medicaid & Private Payor Updates /

(July 5, 2010): The Federal Trade Commission (FTC) has agreed to once again delay enforcement of its illogical and onerous identity theft Red Flags rule with respect to physicians.The Red Flags rule arose under the Fair and Accurate Credit Transactions Act of 2003 and requires “financial institutions” and “other creditors” to develop written plans to […]

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A Look at RACs — Part III: What Medicare Providers Know about RAC Audit Recoupment Rules.

Regulatory Issues | Privacy | Other /

(July 2, 2010): The Centers for Medicare and Medicaid Services (CMS) audit program involving Recovery Audit Contractors (RACs) is now permanent and nationwide. As we discussed in Part I of this series, while small providers were largely ignored during the demonstration program, physicians, home health, hospice, and durable medical equipment (DME) suppliers should be on

A Look at RACs — Part III: What Medicare Providers Know about RAC Audit Recoupment Rules. Read More »

A Look at RACs — Part II: How Should Physicians and Other Providers Respond to a RAC Audit?

Regulatory Issues | Privacy | Other /

(June 29, 2010): In Part I of this series, we reacquainted you with the design and purpose of the now permanent Recovery Audit Contractor (RAC) Program. Although RACs largely focused on inpatient care during CMS’ demonstration program, RACs are a real threat to small providers that don’t have the intensive compliance programs in place that

A Look at RACs — Part II: How Should Physicians and Other Providers Respond to a RAC Audit? Read More »

Enactment of Doc Fix Bill Offers Another Temporary Reprieve for Medicare Physicians

Medicare, Medicaid & Private Payor Updates /

(June 28, 2010): On Friday, June 25, 2010, President Obama signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962), commonly referred to as the Doc Fix, which provides yet another band-aid for our broken Medicare physician pay system. The bill replaces the 21% Medicare physician payment

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RAC Audits of Physician Practices, Home Health, Hospice, and DME Providers, are Expected to Increase.

Home Health & Hospice /

(June 25, 2010): The purpose of this series of articles is to assess the Recovery Audit Contractor (RAC) Program from the perspective of physicians, home health, hospice, durable medical equipment (DME) providers, and other relatively small Medicare providers. As many non-hospital providers will acknowledge, early cries of wolf by law firms and consultants did a

RAC Audits of Physician Practices, Home Health, Hospice, and DME Providers, are Expected to Increase. Read More »

GAO Testimony Recommends CMS Improve Enrollment, Payment, and Oversight Procedures

Medicare, Medicaid & Private Payor Updates /

(June 23, 2010): Yesterday we told you about recent GAO testimony before Congress regarding the impact of health care reform on HHS enforcement efforts. On the same day, GAO Health Care Director Kathleen M. King offered Congress testimony that made clear that the Centers for Medicare & Medicaid Services (CMS) continue to face substantial challenges

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President Obama Publicizes Measures to Reduce Medicare Improper Payment Rate

Medicare, Medicaid & Private Payor Updates /

(June 8, 2010): For those of you who missed the first two dozen pronouncements (okay, perhaps a little exaggerated, but still . . . we got the message when Congress made it a False Claims Act violation to hold onto a mere overpayment for more than 60 days), President Barack Obama has again expressed his

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Responding to a Search Warrant Executed at Your Health Care Practice or Clinic

Medicare, Medicaid & Private Payor Updates /

(June 1, 2010): Like most honest health care providers, you may believe that search warrants are only executed by the government in connection with the investigation of nefarious characters and criminals. Unfortunately, that just isn’t the case. The Federal government has increasingly utilized search warrants as a first-strike investigative tool. In fact, the execution of

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HHS-OIG Reports that Four Medicaid Audit Error Types Accounted For 95% of the Net Improper Medicaid Overpayments

Medicare, Medicaid & Private Payor Updates /

(April 20, 2010): The Department of Health and Human Services, Office of Inspector General (OIG) recently released its report on Medicaid Audits “HHS-Analysis of Improper Payments Identified During the Payment Error Rate Measurement Program Reviews in 2006 and 2007 (A-06-09-00079).” As set out in the report, four types of medical review errors accounted for 95%

HHS-OIG Reports that Four Medicaid Audit Error Types Accounted For 95% of the Net Improper Medicaid Overpayments Read More »

Your Next “Patient” May be an Undercover Secret Shopper Performing a Medicare Audit on Your Practice.

Medicare, Medicaid & Private Payor Updates /

(April 10, 2010): As the American Medical Association (AMA) recently reported on March 22nd, 2010, health care providers may find themselves subjected to a Medicare Secret Shopper audit by fellow health care providers and others hired by the government to conduct undercover reviews and investigations. In a speech he made March 10th, 2010, President Obama

Your Next “Patient” May be an Undercover Secret Shopper Performing a Medicare Audit on Your Practice. Read More »