William H. Stiles
Firm:
Verrill Dana LLP
Phone:(207) 253-4966
Address: One Portland Square
Portland, ME 4112

Membership: MembershipsMaine State Bar Association, Co-Chair, Health Law Section (2001-2003)American Health Lawyers' AssociationHealthcare Financial Management AssociationMaine Hospital Association and Maine Medical Association Confidentiality Law Work Gr
University: University of Oklahoma, B.A., 1991, University of Maine School of Law, J.D., magna cum laude, 1995
Admitted: 1995, Maine; 2000, U.S. Supreme Court; 1999, U.S. Court of Appeals (First Circuit); 1995, U.S. District Court for the District of Maine
Biography: Will enjoys a good challenge. Whether it is involves taking up telemark skiing as a 40- something, or pressing a novel legal theory, his approach is simple: a can do attitude, creative thinking, good old fashioned hard work, and, most importantly, keep it fun (and yes, even Medicare and Medicaid reimbursement can be fun). Although most peoples' eyes glaze over at the mere mention of Medicare and Medicaid regulations, Will has a strange infatuation with making sure that his health care industry clients are properly reimbursed for the important services that they provide. He enjoys appearing before the Medicare Provider Reimbursement Review Board (as well as State Medicaid agency hearing officers), and relishes the opportunity to poke holes in governmental overpayment determinations. He speaks fluent Medicare and Medicaid, including the unique dialects of DSH, TEFRA, CAH, GME, SCH, MDH, MSP and TPL. Will's approach has helped his clients obtain well over $100 million of additional Medicare and Medicaid reimbursement (and has saved his clients millions more defending against overpayment claims). A frustrated closet author at heart, Will believes that a simple and compelling story usually lies beneath even the most complex litigation, and success often depends upon teasing out a simple message, and sharing that story through witnesses, supporting data, and crisp writing. Will is passionate about his family, travel, food and winter. A die-hard “Sugarloafer” (ask me), he hasn't yet given up on his dream of appearing in an extreme telemark ski movie. HonorsListed in The Best Lawyers in America under Health Care Law since 2006 Public ServiceBoard of Directors, WinterKids (June 2011 - present) Advisory Council, The Center for Grieving Children (2011 - present) Board of Directors (Past President), The Center for Grieving Children (2003- 2009) Adjunct Professor, Health Care Law, University of Maine School of Law (2006- present) Publications June 10, 2014 CMS Proposes Significant Changes to the PRRB Appeals Process Alerts and Newsletters William Stiles February 7, 2013 The Auditors are Coming! - Prepare for 340B Audits Alerts and Newsletters January 29, 2013 Ready or Not...The HIPAA Final Omnibus Rule is Here Alerts and Newsletters June 29, 2012 The Supreme Court Upholds the ACA's Individual Mandate, Narrows Medicaid Expansion, and Leaves the ACA Otherwise Intact Alerts and Newsletters February 16, 2012 OIG Alerts Physicians To Exercise Caution When Reassigning Their Medicare Payments Alerts and Newsletters News March 18, 2014 “Cold Swift Justice” Prevails at WinterKids Downhill 24 Press Releases Scott D. Anderson, Kelly B. Boden, Anthony M. Calcagni, Seth S. Coburn, William H. Stiles August 13, 2013 William Stiles Represents Eight Maine Hospitals in Medicare Dispute Media Mentions William H. Stiles July 5, 2006 Two Verrill Dana Attorneys Appointed as Adjunct Professors at the University of Maine School of Law Press Releases William S. Harwood, William H. Stiles Experience Corporate Affiliation Transaction To increase its competitiveness in a changing health care market, a leading Massachusetts academic medical center sought to build a more integrated health care network. The acquisition of another area hospital was a complex, multi-disciplinary effort spanning seven months. Medicare Reimbursement Appeal: $6 Million Recovery Represented a large Maine Hospital before the Medicare Provider Reimbursement Review Board covering four fiscal years. Following a live testimonial hearing, the MAC agreed to enter Administrative Resolutions addressing all years, resulting in over $6 million of additional Medicare reimbursement. Sale of Medicaid Managed Care Plan This is an asset sale of the assets of a 501(3) tax exempt Medicaid managed care plan to a 501(c)(4) Managed Care Plan. Sale of Teaching/Community Hospital Sale of 500-bed teaching/community hospital to the teaching hospital of a major university. Verrill Dana Client Prevails in $1, 123, 462 Appeal to the Medicare Provider Reimbursement Review Board In an appeal to the Medicare Provider Reimbursement Review Board (PRRB) in Baltimore, Maryland, Will Stiles represented a Vermont sole community hospital that experienced a sudden, but unexplained, decrease in the number of Medicare inpatients admitted during its fiscal year 2004. It had applied for a Medicare Low Volume Adjustment Payment, citing a 9.35% drop in inpatient volume from 2003 to 2004, and requested approximately $1.2 million of additional Medicare reimbursement. The Medicare program initially denied the hospital's request in full because the hospital could not explain exactly why inpatient volume had decreased. Verrill Dana Counsel to Lead Intervenor at Dirigo Health Reform Act Hearings Represented lead intervenor Maine State Chamber of Commerce in complex administrative hearings before the Dirigo Health Agency (“DHA”) and Maine Superintendent of Insurance. Verrill Dana Helps Maine Medicare Dependent Hospital Obtain Settlement of $520, 000 from Medicare Represented Maine Medicare Dependent Hospital in an appeal before the Medicare Provider Reimbursement Review Board resulting in a $520, 000 settlement. Verrill Dana Helps Vermont Sole Community Hospital Obtain Settlement of $430, 000 from Medicare Represented a Vermont sole community hospital in an appeal before the Medicare Provider Reimbursement Review Board resulting in a $430, 000 settlement. Verrill Dana Led Medicaid Lawsuit Settles for $85 Million Represented nine Maine hospitals in administrative appeals and lawsuits against the State of Maine Medicaid program that resulted in a landmark $85 million settlement. Verrill Dana Successfully Defends an Alleged Medicaid Overpayment Involving Tens of Millions of Dollars Represented two Maine hospitals in an administrative appeal of an alleged overpayment involving tens of millions of dollars over a six year time period, resulting in an agreement by the State of Maine Medicaid program that no overpayment actually occurred. Events March 26-28, 2014 American Health Lawyers Association Medicare and Medicaid Payment Institute Speaking Engagements William H. Stiles December 6, 2012 Medicare Reimbursement After Healthcare Reform Speaking Engagements William H. Stiles March 30, 2012 American Health Lawyers Association Institute on Medicare & Medicaid Payment Issues Speaking Engagements William H. Stiles