Compliance Conversations by Healthicity

Join Healthicity’s CJ Wolf and Compliagent’s Paige Pennington as they break down the first industry-specific compliance program guidance (ICPG) from the OIG—focused entirely on skilled nursing facilities.  Key Takeaways:  Why the OIG prioritized SNFs  Top risk areas flagged in the new guidance  The evolving role of compliance in quality and contracting  Actionable steps for aligning your risk asse...

In this episode of Compliance Conversations, Anurag Lal , CEO of NetSfere and former U.S. broadband official, explains why healthcare remains the top target for cybercriminals—and what you can do about it.  What You’ll Learn:   The evolving tactics behind healthcare cyberattacks  How to identify insecure communication practices within your org  What true end-to-end encryption really means  Why pat...

From artificial intelligence in audit workflows to CMS’s renewed focus on fraud, waste, and abuse, this episode of Compliance Conversations covers the biggest themes that emerged from HEALTHCON and HCCA’s Compliance Institute. Tune in to hear real takeaways from the exhibit hall, speaker sessions, and side conversations—including why quality of care oversight is gaining new attention. CJ Wolf, MD,...

Audits are an inevitable part of healthcare. But they don’t have to throw your practice into chaos. In this episode, CJ Wolf talks with regulatory and transactional healthcare attorney Christina Kuta, a Shareholder at Roetzel & Andress, about the essential steps providers should take when facing a third-party audit. You’ll learn: - The first three things to do when you receive an audit notice...

Independent Review Organizations (IROs) play a crucial role in healthcare compliance, particularly when organizations are under a Corporate Integrity Agreement (CIA). In this episode of Compliance Conversations, CJ Wolf interviews Stephani Scott, VP of Audit Services at AAPC, on what it really means to be an IRO. You’ll discover: - What IROs do and why independence matters - The key components of...

In this episode of Compliance Conversations, host CJ Wolf chats with Elizabeth Herbert, an Epic Application Analyst with over 25 years of healthcare experience. Together, they break down the myths around EHR templates, offer practical tips for providers and compliance professionals, and explore underused tools that can streamline your day-to-day work. From proper template design to avoiding compli...

In this episode of Compliance Conversations, CJ Wolf and Dan Fox explore the intersection of AI and healthcare compliance. From proactive patient outreach to regulatory risks, they break down how organizations can leverage AI while staying compliant. What You'll Learn: - How AI-driven communication is enhancing patient engagement - The biggest compliance challenges organizations face - Practi...

In this episode of Compliance Conversations, host CJ Wolfsits down with returning guest Sean McKenna, a Partner at Nelson Mullins and former Federal Prosecutor, to explore the critical issues at the intersection of healthcare law and compliance. From the challenges posed by the False Claims Act to the innovative use of data analytics in enforcement, Sean offers firsthand insights drawn from years...

Telehealth is revolutionizing healthcare, but with new opportunities come new risks. In this latest episode of Compliance Conversations, host CJ Wolf welcomes healthcare attorney Susan Walberg to discuss: - Common telehealth fraud schemes—and how to spot them - Compliance pitfalls that could cost your organization - The latest regulatory updates from the FTC, FDA, and HHS - The role of AI in healt...

Join CJ Wolf as he sits down with Clint Narver, a former DOJ prosecutor and healthcare compliance expert, to explore best practices, emerging trends, and real-world strategies for avoiding legal pitfalls. Highlights: - Learn how to safeguard your organization against research fraud. - Insights into the DOJ’s perspective on compliance programs. - Real-life examples of compliance missteps and how to...

Selling or acquiring a healthcare practice is no small feat. Regulatory compliance challenges, from Stark Law violations to billing audits, can derail even the best-planned transactions. In this insightful episode of Compliance Conversations, CJ Wolf interviews Ericka Adler, a leading healthcare attorney and Shareholder at Roetzel & Andress, to uncover: - The most common compliance pitfalls in...

Join us for an eye-opening conversation on Compliance Conversations, where CJ Wolf interviews Nick Sahar, founder of Semantic Health and pioneer in AI for medical coding. In this episode, you’ll learn: - How AI enhances coding accuracy and speeds up workflows. - Practical use cases for AI in coding, auditing, and clinical documentation. - What the future holds for AI in healthcare compliance. Don’...

In this episode of Compliance Conversations, CJ Wolf welcomes Dave Cardelle to discuss the payer perspective on payment integrity. From the complexities of DRG claims to the use of AI, this conversation sheds light on how automation and collaboration can transform the healthcare landscape. What you’ll gain: - A deep dive into DRG audits and common pitfalls. - The role of technology in reducing abr...

In the latest episode of Compliance Conversations, CJ Wolf welcomes Jay Anstine back to explore the nuances of effective compliance communication. What You’ll Learn: - Strategies for delivering tough news to leadership - How to avoid creating a culture of false urgency - Practical tips for navigating compliance politics - The importance of clear communication plans Jay draws on years of healthcare...

We’re excited to share a new episode of Compliance Conversations where CJ Wolf, MD talks with healthcare compliance expert Nancy Clark, the Senior Manager of Health Care Services at EisnerAmper! In this episode, Nancy brings decades of experience in coding and revenue management to address improper payments—a costly issue for healthcare providers. Listen in as we dive deep into: - The most common...

We’re thrilled to announce a major milestone for Compliance Conversations – our 100th episode! Over the years, we’ve had the privilege of hosting industry experts to hear their invaluable perspective on best practices, trends, and real-world scenarios in compliance and auditing. This special episode is a celebration of our journey and the incredible community that’s made it possible! Join CJ Wolf,...

In this episode, CJ Wolf, MD, and E/M coding expert Sharisa Freeman discuss her journey and insights into mastering the complexities of E/M coding. Here's a quick look at what you can expect from this episode: - The Evolution of E/M Coding: Changes in guidelines that shifted the focus to Medical Decision Making. - Medical Decision Making Tips: Understanding the three essential sub-elements: n...

Ever wondered what it’s like to testify as an expert witness? We talk about that and more in this episode of Compliance Conversations! We invited compliance expert Rebecca Busch to explore her incredible journey from trauma nurse to legal expert in healthcare fraud and compliance. Join us as Rebecca shares: - Her transition from nursing to healthcare fraud examination - The key legal challenges in...

Tune in to this episode of "Compliance Conversations" where we dive deep into the world of innovation and biotech with our special guest, Steve VanNurden! In this episode, CJ Wolf, MD, talks with Steve VanNurden, CEO of Fitzsimons Innovation Community and Associate Vice Chancellor of Biotechnology at the University of Colorado Anschutz Medical Campus. Listen in as they explore the unique...

In this episode, Maeve O'Neill, MEd, LPC-S, CHC, CDTLF, the National Compliance Director for Circa Behavioral Healthcare Solutions, joins us to share insights from her three decades of experience in mental health and addiction services as she provides valuable insights into the unique challenges and best practices for compliance in this field. Tune in as we discuss: - The complex web of regul...

Medicare audits can be a daunting challenge for any healthcare provider. With a maze of regulations, different types of audits, and a complex appeal process, it’s easy to feel overwhelmed. That’s why we invited Alicia Shickle, AHFI, CHC, CPC, CPCO, CPMA, CRC, the President and CEO of ProCode Compliance Solutions LLC, to share the knowledge and strategies you need to navigate this tricky terrain. T...

Heidi McKinnon, PharmD, CHC, a seasoned compliance expert, shares insights from her journey from retail pharmacy to head of compliance at Capital Rx, a leading pharmacy benefit manager. In this episode, Heidi shares her unique path and extensive experience in the compliance world. We delve into the evolving landscape of digital pharmacy, discussing: - The true meaning of digital pharmacy and how i...

In this episode, we welcome back Hal McCard, Counsel at Spencer Fane, to delve into the complexities of financial relationships with physicians, including essential insights on compliance with STARK and Anti-Kickback statutes. CJ Wolf, MD, and Hal McCard discuss: - Hal’s extensive career in healthcare law and his journey to becoming a leading expert in the field. - Detailed explanations of STARK a...

Are you intrigued by the rapid evolution of telehealth and its impact across the globe? Then you won’t want to miss our latest podcast episode where Keisha Wilson and CJ Wolf discusses the nuances, challenges, and opportunities in international telehealth services! In this episode, we discuss: COVID-19’s Impact on Telehealth: Learn how the pandemic prompted a reevaluation of international teleheal...

In this episode, our host CJ Wolf sits down with Laidy Diana Martinez, a coding supervisor, to discuss the world of GI coding and compliance. Episode Highlights: - Introduction to GI Coding Challenges: Understand the common hurdles and how to overcome them. - Screening vs. Diagnostic Colonoscopies: Learn the critical differences and their coding implications. - Essential Modifiers: Find out which...