Monitor Mondays

Spike in Audit Activity Sets Off Alarm Bells: A Regulatory News Update

August 09, 2021 Ronald Hirsch, MD | Knicole Emanuel, Esq. | David Glaser Esq. | Ellen Fink Samnick | Matthew Albright | Mary Inman, Esq. | Gloryanne Bryant Season 11 Episode 465
Monitor Mondays
Spike in Audit Activity Sets Off Alarm Bells: A Regulatory News Update
Show Notes

Medicare and Medicaid auditors are becoming more and more aggressive, threatening the livelihood of providers willing to accept such federally covered beneficiaries.

Should there be an act of Congress to pass legislation to address this? How long will aggressive auditing that allows third parties to run roughshod over providers continue? To learn the extent of recent auditing activities, listen to the next live edition of Monitor Mondays, coming your way on Monday, Aug. 9 at 10 a.m. EST.

You’ll also learn about the extraordinary move by the U.S. Department of Justice (DOJ) to intervene in whistleblower lawsuits brought by Constantine Cannon against Kaiser Permanente, one of the nation’s largest managed care organizations (MCOs), which has been accused of knowingly submitting false claims for risk-adjusted payments to the Centers for Medicare & Medicaid Services (CMS). Famed whistleblower attorney Mary Inman, partner in the London office of Constantine Cannon, will return to the broadcast next Monday to report on this developing story.

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 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, a nationally recognized expert on the social determinants of health (SDoH), will have the latest news on a trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listeners Survey.