Monitor Mondays
Join Chuck Buck every Monday when he welcomes RACmonitor contributing editors and special guests for the latest regulatory audit news and information from CMS, OIG and OMHA. And gain valuable context and perspective that can only be found when you’re listening to the long-running and popular Monitor Mondays. Register to attend live here: https://racmonitor.medlearn.com/racmonitor/podcasts/
Podcasting since 2018 • 373 episodes
Monitor Mondays
Latest Episodes
Court Vacates RAVD 2023 Final Rule
Recently, a federal court vacated the Centers for Medicare & Medicaid Services 2023 Risk Adjustment Data Validation (RADV) Final Rule.This action is reshaping the landscape for Medicare Advantage compliance. The rule had authorized c...
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Season 14
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Episode 654
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29:41
Into a Rabbit Hole: Medical Loss Ratio Fraud Detected in Managed Care Program
A recent case filed by the U.S. Department of Justice (DOJ) reveals how an insider was able to detect fraud in a large managed care organization (MCO).Although the topic of medical loss ratio (MLR) might be arcane to some, when the subject ...
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Season 14
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Episode 653
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28:55
Whistleblowers Bring Total Knee Replacement DME to its Knees
Three whistleblowers brought a durable medical equipment (DME) provider to its knees.In two separate cases, the whistleblowers targeted Exactech, a manufacturer of total knee replacement (TKR) systems, resulting in a settlement of $8...
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Season 14
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Episode 652
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28:14
When Whistleblowers Can’t Whistle
Healthcare compliance just shifted fundamentally.Traditional whistleblowers who needed inside access are being replaced by artificial intelligence (AI)-powered relators who mine public datasets and flag statistical anomalies that could sign...
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Season 14
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Episode 651
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29:55
