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Liles Parker Attorney Presented at the West Virginia Physician Summit

Firm News /

(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 […]

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“Under the Fifth Amendment, You Have the Right to Remain Silent.” Well. . . Maybe Not.

Regulatory Issues | Privacy | Other /

(July 3, 2013):Everyone reading this article is likely familiar with the phrase “You have the right to remain silent.” In fact, a citizen’s right to remain silent is considered the cornerstone of an individual’s Fifth Amendment right against self-incrimination. As you may recall, the Fifth Amendment to the Constitution provides: “No person shall be held

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A TMB Complaint is Serious Business — Don’t Take the Texas Medical Board Complaint Process Lightly

Medicare, Medicaid & Private Payor Updates /

(February 10, 2013): Texas physicians face a myriad of challenges each and every day. In an era when reimbursement rates are declining yet many expenses are continuing to rise, physicians are also seeing many of their services co-opted by physician assistants and nurse practitioners, thereby further increasing competitive pressures. Unfortunately, these challenges only represent the

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Individual Liability for Medicare Overpayment Claims

Medicare, Medicaid & Private Payor Updates /

(October 19, 2012): This article addresses the case where an individual or “natural person” owns an interest in a Medicare health care provider which is incorporated[1] under the laws of a state, as a corporation, limited liability company, limited partnership, or another type of legal person. The individual may be a shareholder, member, limited partner,

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National Site Visit Contractor Established

Medicare, Medicaid & Private Payor Updates /

(May 24, 2012): The Centers for Medicare & Medicaid Services (CMS) is rolling out a new survey initiative, known as the “National Site Visit Contractor” program. In updates to the Medicare Program Integrity Manual released on April 6, 2012 and April 13, 2012, CMS has somewhat quietly introduced the National Site Visit Contractor program, noting

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RAC-Initiated Medicare Prepayment Reviews Will Soon Begin.

Medicare, Medicaid & Private Payor Updates /

(February 7, 2012): In recent years, physicians and other health care providers have faced a wide number of administrative actions and sanctions levied by contractors working for the Centers for Medicare and Medicaid Services (CMS). Zone Program Integrity Contractors (ZPICs) have subjected physician practices to Medicare prepayment reviews, postpayment audits, suspension and / or revocation

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Health Integrity Audits of Texas and Oklahoma Home Health Agencies are on the Rise.

Home Health & Hospice /

(August 14, 2011): Home health agencies in Texas and Oklahoma remain under considerable scrutiny by Medicare contractors tasked with identifying fraud and abuse perpetrated against the Medicare Trust Fund. As discussed below, these Medicare contractors have a number of tools at their disposal, many of which can effectively place a home health agency in financial

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Ten Recommendations to Improve Medicare Compliance and Prepare for a ZPIC Audit

Medicare, Medicaid & Private Payor Updates /

(July 24, 2011): Has your Texas physician practice, home health agency, hospice, DME company or PT / OT / ST clinic been audited by a Zone Program Integrity Program (ZPIC)? If not, it may only be a matter of time. Despite your best efforts to follow Medicare’s directives, your organization may still be identified as

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NCI-Owned AdvanceMed Will Remain the ZPIC Responsible for Zones 2 and 5.

Medicare, Medicaid & Private Payor Updates /

(April 10, 2011): Last week, it was announced that NCI, Inc., one of the nation’s most successful information technology companies had acquired the outstanding capital stock of AdvanceMed Corporation (AdvanceMed), an affiliate of CSC. While the acquisition went largely unnoticed by the health care provider community, the transaction may, in fact, be quite significant. With

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CERT Postpayment Audits: An Overview of the Audit Process

Medicare, Medicaid & Private Payor Updates /

(March 12, 2011): Health care providers around the country are finding their practices and clinics subjected to Medicare post-payment audits by Zone Program Integrity Contractors (ZPICs), Program Safeguard Contractors (PSCs) and Comprehensive Error Rate Testing (CERT) Contractors. While all post-payment audits should be taken seriously, there are real differences between both the contractors and the

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