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Michael Cook Moderating a panel of State Medicaid Directors and Deputies

December 18, 2018 by  
Filed under Firm News

Michael Cook will be moderating a panel of State Medicaid Directors and Deputies on “The Future of the Medicaid Program in Long Term Care – A Panel of State Government Experts” at the American Health Lawyers Symposium on Long Term Care.  The Symposium will be held in Phoenix, Arizona from February 27 – March 1, 2019, and in addition to Michael, the panel will include the Directors of the Medicaid program from Virginia, Washington state and Arizona.

Liles Parker’s Attorney Ashley Morgan named a ” Super Lawyer — Rising Star “

November 19, 2018 by  
Filed under Firm News

Super LawyerIt is official! Associate Attorney Ashley Morgan has been named a ” Super Lawyer — Rising Star ”

Additionally, she passed the Certified Professional Coder exam and is now a Certified Coder!

 

My Weekend Volunteering at the Wise County Free Clinic

August 14, 2018 by  
Filed under Firm News

On the weekend of July 20 – 22, I joined a number of people from the Virginia Department of Medical Assistance Services (“DMAS”) in traveling to Wise County Virginia to volunteer for the annual free clinic that is offered in that County.  Our group was led by the Director of DMAS, Jennifer Lee, MD, who is trained as and ER physician.  As background, DMAS is the State agency that administers the Medicaid program in Virginia, and I was appointed several years ago by Governor McAuliffe to the Board that advises DMAS.

The Wise County free clinic offers a once a year opportunity for people in Wise and surrounding counties and states to obtain free medical, dental, vision care, PT and radiology, as well as to receive free food and clothing.  The clinic is held outside in a Fair Ground, although certain dental services, such as dentures, were provided at another proximate offsite location, and resembles what I would imagine a MASH unit, to look like.

A significant number of dentists and dental students and medical and medical students were perhaps the most important volunteers.  In the past, Ralph Northam, Virginia’s current Governor and a pediatric neurologist, has also volunteered and this year visited clinic.  The remainder of us volunteered in such capacities as “runners” – individuals who make sure that patients are appropriately moved through the process and also to assist in delivering the free food to patients who are awaiting services and do not wish to lose their place in the cue, staff to make corrective lenses and fit them into optical frames that are offered on that date, preparation and delivery of snack and meals to people at the clinic and volunteers, and frankly, anything else that the clinic needs.

As a volunteer, I had the opportunity, not only to assist, but also to meet a number of people who were having multiple dental and medical needs attended.  These people by and large had many needs but also a stoicism and gratitude for the assistance that they were receiving that was both heart-warming and tragic.  I cannot tell you the number of people who I escorted to the dental tent who were facing the need to extract all of their remaining teeth.  It is a tragedy that a country such as ours should never allow to occur.

There is also silver lining here.  The Virginia legislature recently voted to expand the Medicaid program effective January 1, 2019.  Virginia’s Medicaid program does not cover adult dental care, and many medical needs are related to the lack of adequate dental care.  However, there is hope that the expansion will enable a number of folks who have needed to rely on the Wise County free clinic, and thus avoid waiting at least a year (and sometimes many years since the clinic cannot serve everyone who presents), to receive medical care on a regular basis throughout the year.

The importance of the expansion to these folks is best demonstrated by the fact that as part of service that weekend, the DMAS contingent also offered outreach to alert the attendees of the advent of the expansion on January 1.  The receptiveness of the patients can only be described as overwhelming.

I was privileged to join a group of committed individuals from DMAS who gave up their weekend and traveled at their own expense to assist.  I was even more privileged to be able participate and assist in the delivery of care to so many needy folks.  I can only hope that at some point in my life time, this becomes obsolete and that routine medical and dental care becomes accessible for everyone.

Healthcare AttorneyMichael Cook is a Partner and Co-chair of the Health Care Group at Liles Parker PLLC.  Mr. Cook has extensive experience in representing providers and suppliers of all types, including home and personal, and home health, agencies in regulatory, compliance, policy, and business matters throughout the country.  Mr. Cook also serves on the Board of the agency that advises Virginia’s Medicaid program. Anyone interested in discussing the material presented in this article should contact Michael Cook at 202-298-8750 or mcook@lilesparker.com

Michael Cook appointed to serve on Virginia’s Medicaid Policy Council

January 2, 2018 by  
Filed under Firm News

Healthcare Attorney(January 2, 2018):  Congratulations to our very own Michael Cook who has been appointed to serve on the Virginia Medicaid Policy Council for Health and Human Resources. In this role, The Council’s role is to provide recommendations on policy issues involving the programs operated by the Department of Health and Human Resources as part of the transition.

It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions

November 23, 2016 by  
Filed under Firm News

(November 23, 2016): Michael Cook, co-chair of the Health Care Group, has an article published in the October issue of the American Health Lawyers Association Journal of Health Law & Life Sciences entitled “It’s Time for CMS and Congress to Review Outdated Medicare and Medicaid Provisions.”  The article discusses the fact that given the dramatic changes in payment and delivery system reform, there are a number of outdated, and in some instances counter-productive, rules that no longer make any sense and that should be reviewed by CMS and Congress.  The article cites three examples – the three day hospital stay requirement for Medicare SNF coverage, the limitations for coverage of care in Institutions for Mental Diseases and psychiatric hospitals under Medicaid, and for certain circumstances in alternative payment systems, the homebound requirement for Medicare home health coverage, but there likely are many more that will need examination in the coming years.  Ashley Hudson, an associate of the Firm, assisted in the research for the article.

The article can be reviewed at http://www.healthlawyersjournal.com/healthlawyers/october_2016/?pg=24&pm=2&u1=friend.

Outdated Medicare and Medicaid ProvisionsMichael has more than 40 years’ experience representing clients on health care issues in government and in private practice, serves on the Board of Medical Assistances Services that oversees Virginia’s Medicaid program, and also has advised a number of campaigns of candidates for state and national political offices.  Michael and Ashley can be reached at 202-298-8750.

Liles Parker’s Michael Cook Appointed to Virginia Board of Medical Assistance Services

March 20, 2015 by  
Filed under Firm News

Michael Cook(March 20. 2015): Liles Parker is proud to announce that Governor Terry McAuliffe (VA) has appointed Michael Cook, co-chair of our health care group, to a four-year term as a member of the Virginia Board of Medical Assistance Services.  The Board is established pursuant to Virginia statute to oversee the Medicaid program, including the development of the State Plan for Medical Assistance and promulgating rules and regulations for the Medicaid program.  Michael has a wealth of experience in working with the Medicaid program, initially as an attorney for the federal regulators of the program, and for more than 30 years representing providers in the program.  Additionally, Michael has served previously on a work group of Governor Kaine’s Health Reform Commission, has served on the health care transition team for two Governors, and has lectured and published frequently over the years on health care issues, including those involving the Medicaid program.  We congratulate Michael on his appointment.

Dixon Conference 2015: Home Health

November 13, 2014 by  
Filed under Firm News

LP Vegas Home Health Dixon

Liles Parker Attorney Presented at the West Virginia Physician Summit

August 26, 2013 by  
Filed under Firm News

Liles Parker attorney presented at the West Virginia Physician Summit(August 26, 2013):  Medicare compliance challenges have increased (rather than decreased) with the passage of the Affordable Care Act and the implementation of Electronic Medicare Records (EMR) systems by physicians and other health care providers around the country.  Late last week, Robert W. Liles, Managing Partner at Liles Parker, had the privilege of serving as a keynote speaker at the plenary session of the West Virginia Medical State Association’s annual conference.  The 2013 West Virginia Physician Summit was conducted at the historic “Greenbrier,” located in White Sulphur Springs, West Virginia.  As Robert’s presentation discussed, it is more important than ever that physicians identify and address any Medicare compliance risks facing their practice. Robert’s presentation outlined the following physician, practice group, and Medicare compliance challenges:

Risk #1: ZPIC / RAC / MAC Post-Payment Audits of Physician Claims Billed to Medicare.

Risk #2: Increased Likelihood of Pre-Payment Reviews by ZPICs.  Plus, RAC Pre-Payment Reviews are Now Here.  Rise of the UPICs!

Risk #3: Increased Possibility of Criminal Referral, Suspension or Revocation Action Recommended to CMS by ZPICs and RACs.  

Risk #4: Increased Risk of Statutory Violations Due to Changes Under the Affordable Care Act (ACA).

  •  Failure to return overpayments within 60 days.
  • Loosening of proof standards to show a violation of the Federal Anti-Kickback Statute.
  • Expansion of the Medicare permissive exclusion rules.
  • Importance of Medicare Compliance.

Risk #5: Increased Prosecutions by HEAT Teams Around the Country.

Risk #6: Increased Sanctions and Level of Risk Associated with Violations of HIPAA and/or HITECH Privacy Requirements.

Risk #7: Increased Collection and Investigative Activity by Private Payor SIUs.

Risk #8: Increased Enforcement by HHS-OIG of CMP Actions for Failure to Screen Employees.

Risk #9: Increased Audit and Investigative Actions by MFCUs, MICs and Medicaid RACs.

Risk #10: Increased likelihood of Qui Tam and/or Government False Claims Act cases against Providers. 

In addition to the Medicare Compliance risks outlined above, Robert discussed the importance of conducting a “Gap Analysis” so that any deficiencies (in coding, billing or in business practices) could be identified and remedial steps could be taken, thereby bringing a practice into regulatory alignment with Medicare Compliance mandates. Is your practice currently facing a pre-payment review or a post-payment audit, please give us a call so we can discuss your options for responding to the CMS contractor’s actions.

Healthcare LawyerRobert W. Liles serves as Managing Partner at the law firm, Liles Parker, PLLC (Liles Parker).  Our firm is a boutique health law firm with offices in Washington, DC, Houston, TX, McAllen, TX and Baton Rouge, LA.  We represent physicians, group practices and others health care providers around the country in connection with statutory and regulatory health care issues that may arise.   For a complimentary consultation, please give us a call at:  1 (800) 475-1906.

Liles Parker Attorney Achieves Recognition as a Certified Medical Compliance Officer – CMCO

March 17, 2013 by  
Filed under Firm News

Healthcare Lawyer(March 18, 2013): Liles Parker is pleased to announce that one of its Associate Attorneys, Ms. Lorraine Ater,  has completed the “Certified Medical Compliance Officer” course and passed the examination offered by Practice Management Institute (PMI), one of the oldest and most recognized medical education suppliers in the country.   Unlike other courses, PMI’s Compliance Officer certification course is believed to be the first comprehensive live course in the country focused on non-hospital medical office environments.   The curriculum has been rated as excellent and has also recently been approved for physician CEU credit. As Managing Partner David Parker stated:

“Liles Parker has always encouraged its staff to participate in continuing medical and legal education.  As a Certified Medical Compliance Officer, Lorraine is trained to understand our health care provider client’s business needs and better assist them when we conduct “GAP analyses” of a their medical office or clinic.  We are proud of Lorraine and look forward to working with her on our compliance projects for many years to come.”

Lorraine currently works as an Associate Attorney in Liles Parker’s Health Law Section.  She received her law degree from Lewis and Clark Law School in Portland, Oregon.  While in law school, she was selected to serve as an extern from her law school to work in the chambers of Senior Advocate Shyam Divan in New Delhi, India.  While there, she gained valuable experience conducting legal research and writing legal memoranda on matters before the Supreme Court of India.  She was awarded a Global Law Scholar Award by Lewis and Clark for her work.

Prior to law school, Lorraine attended Union College in Schenectady, New York, where she received a B.A. in Political Science, as well as a Minor in German (notably, Lorraine is fluent in German).  In her final year, she was the recipient of the Alvin F. Nitchman Prize, a prize awarded to the most promising senior who plans to attend law school.  Lorraine was selected from our staff candidates to take the PMI Compliance Certification course based on her growing expertise working with health care providers and suppliers around the country on regulatory and compliance-related projects.

Lorraine Rosado J.D., and Liles Parker’s other health care attorneys have extensive experience working with health care providers and suppliers around the country on a full range of compliance-related projects.  For a free consultation, please give Lorraine a call at: 1 (800) 475-1906.   

HBMA Journal Includes Cloud Computing Article by Liles Parker Attorney in its Latest Edition

December 4, 2012 by  
Filed under Firm News

(December 4, 2012):  This month, the Healthcare Billing & Management Association’s (HBMA) Journal, Billing, features an HBMA Journal article written by Robert W. Liles, Managing Partner at the firm. Entitled “Be Careful Before Moving to Cloud Computing: A Contrarian View of the Inevitable,” the article tackles many of the current risks associated with the use of cloud computing and cloud service providers (CSPs). The article describes the different types of clouds available, some of the cost-saving benefits of using CSPs, and the myriad concerns associated with its use. Touching on providers’ obligations to protect and secure protected health information (PHI), the article covers several important points that all health care practitioners should understand when determining whether and how to adopt this technology. It also provides an interesting discussion on the government’s current reticence to allow federal agencies to use the services of a CSP.

As this article shows, cloud computing isn’t necessarily the panacea it is portrayed to be by its many supporters.  Even when handled with care, cloud computing exposes a provider to an unprecedented new level of risk — one in which no amount of planning or due diligence can fully reduce the potential for a breach if a CSP either employs a rogue staffer, goes out of business or moves its operations beyond the reach of American law enforcement.

At the end of the day, health care providers are left with a simple question to decide:

“Are the real and measurable benefits of convenience and cost-savings achieved through the use of cloud computing worth the additional, difficult to measure and largely uncontrollable risks that are likely to be inherent in any cloud computing business arrangement?” 

Robert has written extensively on cloud computing and other health care compliance issues. Learn more about cloud computing here.

Robert LilesHealthcare Lawyer counsels providers on HIPAA compliance risks, HIPAA breach notification issues and the development and implementation of effective Compliance Plans.  In addition, Robert performs gap analyses and internal reviews, trains healthcare professionals on compliance issues, and represents providers in Medicaid and Medicare audits and appeals. For a free consultation, call Robert today at 1-800-475-1906.

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