Assistant Attorney General and the head of the Criminal Division at the Department of Justice, Kenneth Polite sits down for a candid discussion with Sean to explore a variety of topics including: Why compliance programs are so important to DOJ... The benefit of Compliance Certifications Proffers where corporate attorneys are driving the responses vs the compliance officer of the organization... Regulatory changes for telehealth services The Ryan-Haight Act, what is it and its impact on prescribing narcotics... Telemedicine fraud since the PHE... and The Criminal Division’s Corpora ..read more

On March 15th Sean put out a blog post on Cigna and their new demand for documentation when an EM and minor procedure is performed on the same day with the modifier 25 appended. Don't miss this one ..read more

In this episode Sean breaks down the False Claims Act and the Health Care Fraud Statute. This is a very detailed breakdown of both laws with some insight to the proposed language change to the Medicare Voluntary Refund (60-Day Rule).  ..read more

Terry and Sean sit down to discuss the latest investigation and prosecutions tied to telehealth services performed by providers engaging in contractual arrangements with 3rd party telefraud companies to perform medical necessity reviews for DME prescribed by other providers! You do not want to miss this one!  ..read more

In this episode Sean is joined by the all star cast of subject matter experts to discuss topics impacting healthcare operations and compliance!  ..read more

The full cast of #characters is back for another #allstart panel discussion on #thecomplianceguy! This is a show you are not going to want to miss: 1. Computer Assisted Coding (CAC) - What is it and the reasons why providers are facing potential #falseclaimsact allegations! 2. The routine waiver of co-payments and/or deductibles - What the OIG and DOJ have to say about it, and why it's illegal! 3. Coding certifications - The state of coding and what's transpiring that puts the industry at significant risk! Christine Hall CHC CPC , CPB, CPMA, CRC, CEMC, CPC-I Terry A Fletcher BS CPC CEMC C ..read more

Robert Liles, ESQ. sat down with Sean to discuss an array of topics impacting and potentially impacting health care providers and professionals in the near future! There is so much to unpack in this episode...  ..read more

Jordan Johnson sits down with Sean to discuss the FTC proposal regarding Noncompete Agreements, Hospital CEO Salaries vs. Nurses and so much more!   ..read more

Terry joins Sean to discuss Incident-to and all the headaches that comes with billing this provisional service.  ..read more

Once again the all star panel of subject matter experts (Terry, Christine, Scott, Paul, and Stephanie) join Sean to discuss some of the most pressing issues impacting the healthcare industry! 1. Medicare ABN vs. Commercial Payer Waiver of Liability  2. EM Services - How and when time drives pre 2021 services 3. The ins and outs of psych services 4. Mergers and take-overs in healthcare and the potential impact ..read more