An older physician, practicing family medicine for 46 years, opens his door one day and finds an individual who says he works for the U.S. Department of Justice (DOJ), demanding to see medical records.
In short order, the agent leaves the premises with charts, and later, the family physician finds himself facing the prospect of a trial by jury that the DOJ is demanding to quantify civil monetary fines and penalties. What could have possibly triggered this investigation?
Reporting this developing story during this edition of Monitor Mondays is Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS). DeConda, who personally talked to the rural West Virginia physician, will report on the latest development in the case of a healthcare professional who plans to tell a jury of his peers that he didn’t swindle Medicare for money at their expense.
Other segments to appear during the live broadcast include:
- RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group.
- Monday Focus: John K. Hall, MD continues his reporting on the now-infamous blog post of May 2, by Seema Verma, the Centers for Medicare & Medicaid Services (CMS) administrator. Hall reports that he expects that providers can expect more Recovery Audit Contractor (RAC) audits as a result of her blog. Hall is the founder of the Aegis Firm.
- SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SdoH), has the latest news on this trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listener Survey.
- Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on Split Shared Evaluation and Management EM Services.
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.