Monitor Mondays

Rampant RACs: Auditor Industry Profiting at Providers’ Expense

July 19, 2021 RACmonitor Season 11 Episode 462
Monitor Mondays
Rampant RACs: Auditor Industry Profiting at Providers’ Expense
Show Notes

Edward Roche, JD, PhD
Director, Scientific Intelligence, Barraclough NY LLC

Matthew Albright; Knicole Emanuel, Esq.; Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP;
David Glaser, Esq.; and Ronald Hirsch, MD, FACP, CHCQ

RACmonitor investigative reporter Ed Roche is intimately familiar with what he describes as the blatant abuse directed at healthcare providers by overzealous (and, in some cases, incompetent) auditors.

Relying on scant evidence of actual fraud, the auditors, working in what Roche describes as a giant industry, deny claims while ignoring more the egregious cases of premeditated fraud and abuse. During the next live edition of Monitor Mondays, Roche will be calling for major reform of these auditing practices, claiming in an exclusive segment that the sprawling industry of coding experts, consultants, lawyers, and statisticians seldom catch the real perpetrators of fraud and abuse.

Other segments to be featured during the live broadcast include the following:

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return to make his Monday Rounds with another installment of his popular segment.
  • RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.
  • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.
  • Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington, D.C.
  • SDoH Report: Ellen Fink-Samnick,anationally recognized expert on the social determinants of health (SDoH), will have the latest news on this trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listeners Survey.