William H. Stiles

William H. Stiles: Attorney with Verrill Dana LLP
  • Counsel at Verrill Dana LLP (129 Attorneys)
  • One Portland Square, P.O. Box 586, Portland, ME 04112-0586
    View William H. Stiles's office location
  • Will has handled health care law matters, both simple and complex, since 1995. He maintains a general health law practice with an emphasis on hospital law; Medicare and Medicaid audits, appeals and litigation; and health care licensing and compliance, including EMTALA, Stark and Anti-Kickback issues. He has served as a trusted counselor and advisor to numerous hospitals, nursing facilities, physician groups, pharmacies, and billing companies.




    Will is best known for his work with Medicare and Medicaid issues, having represented providers throughout New England in matters involving reimbursement planning, individual and group administrative appeals, and lawsuits. His extensive experience with Medicare and Medicaid reimbursement includes disproportionate share hospital (“DSH”) adjustment payments, Graduate Medical Education (“GME”), Indirect Medical Education (“IME”), TEFRA adjustments and exceptions, Critical Access Hospital (“CAH”) issues, Sole Community Hospital (“SCH”) issues, Third Party Liability (“TPL”), Medicare self-disallowed costs, related party costs and bad debts, among others. Through Will’s efforts, his clients have received well over $100 million dollars of additional Medicare and Medicaid reimbursement.

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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 ensuring that his health care industry clients are correctly reimbursed for the important services 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, Bad Debts 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 tens of millions more defending against overpayment claims).

A frustrated author at heart, Will believes that a compelling story lies beneath even the most complex litigation, and success often depends upon teasing out a simple message, and sharing it through well-prepared witnesses, strong supporting data, and crisp writing.

Outside of the office, Will enjoys creating a dynamic and supportive community by volunteering time with non-profit agencies, boards and committees. In 2012, Will helped to create the WinterKids’ Downhill 24, a 24-hour team alpine ski race that raises hundreds of thousands of dollars each year to help children lead healthy lives.

Will is passionate about his family, travel, food and winter. A die-hard “Sugarloafer” (ask me), Will has not yet given up on his dream of appearing in a Warren Miller ski movie.

Honors

Listed in The Best Lawyers in America under Health Care Law since 2006, and
Litigation - Health Care since 2018

Public Service

Board of Directors, WinterKids (June 2011 - present)
Advisory Council, The Center for Grieving Children (2011 - present)
Board of Directors, The Center for Grieving Children (2003 - 2009)
Adjunct Professor, Health Care Law, University of Maine School of Law (2006 - 2008)

Highlights

Selected for inclusion in The Best Lawyers in America 2019.

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.

News

March 18, 2014
“Cold Swift Justice” Prevails at WinterKids Downhill 24
Press Releases
Scott D. Anderson, 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

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

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

Areas of Practice (2)

  • Health Care
  • Health Care Litigation

Education & Credentials

Contact Information:
(207) 253-4966  Phone
(207) 253-4967  Fax
www.verrilldana.com/wstiles
University Attended:
University of Oklahoma, B.A., 1991
Law School Attended:
University of Maine School of Law, J.D., magna cum laude, 1995
Year of First admission:
1995
Admission:
2000, U.S. Supreme Court; 1999, U.S. Court of Appeals (First Circuit); 1995, U.S. District Court for the District of Maine; 1995, Maine
Memberships:

Memberships

Maine State Bar Association, Co-Chair, Health Law Section (2001-2003)
American Health Lawyers' Association
Healthcare Financial Management Association
Maine Hospital Association and Maine Medical Association Confidentiality Law
Work Group (1998 and 1999)
Maine Hospital Association HIPAA Work Group (2001)

ISLN:
910098654

Peer Reviews

Client Reviews

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Disclaimer

Documents (2)

Documents by this lawyer on Martindale.com

Portland, Maine

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