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/
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Oig Podcasts
Inside Oversight is an official podcast of the Department of Veteran Affairs, Office of Inspector General. Each episode examines in detail some of our more nuanced oversight reporting. To understand the complexities of the topics, we talk with the report authors to gain insight into how the team conducted its work, what it found, and the impact on veterans and the public. Visit the VA OIG website for recently published reports.
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Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals. The show features interviews of industry leaders, government officials, and others helping to shape the healthcare landscape. Sean M. Weiss (AKA – The Compliance Guy) has been an industry respected name for more than 25-years. A physician and health system ...
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Veteran Oversight Now is an official podcast of the Department of Veteran Affairs, Office of Inspector General. Each episode features interviews with key stakeholders, discussions on high-impact reports, and highlights of recent oversight work. Listen regularly for the inside story on how the VA OIG investigates crimes and wrongdoings, audits programs that provide benefits and services to veterans, and inspects medical facilities to ensure our nation’s veterans receive safe and timely health ...
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Sonal Patel, CPMA, CPC, CMC, ICD-10-CM serves as the host on her Paint The Medical Picture Podcast series. The series is focused on providing listeners with the latest healthcare industry news in medical coding, medical billing, auditing, compliance, and reimbursement. It dives into best practice tips to improve clinical documentation and coding accuracy to garner correct reimbursement levels the first time around. The series will also include updates on cases of fraud, waste, and abuse to h ...
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Listen to Interview about USPS on WZRD 88.3 fm radio Chicago Karen M. Nielsen USPS Employee Also see: UnemployDeJoy.com and google: Dominick VS Louis DeJoy (The Guardian). Also IWP DeJoy. Hi I'm KaRi. I started TPSradio in 1999, podcasting Feb 2005. The rage became "Live Internet TV" (mogulus, etc.) in 2008 and in 2012 TPS returned to cable access TV. TPS college radio was heard on campus at CSULB via the internet, live webcast with simultaneous audio broadcast over Community Television. TPS ...
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Dentists face numerous regulatory and liability issues, and keeping up with them can be daunting at best and career ending at worst. Join host Duane Tinker (AKA "The Toothcop") as he tackles these critical issues, offering valuable insights and easier solutions to apply at your dental practice.
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On September 28, 2012, Massachusetts state chemist Annie Dookhan was arrested and charged with obstruction of justice and falsification of academic records. Approximately four months later another chemist, Sonja Farak, was arrested for using the drugs she was supposed to be testing and the Massachusetts Drug Lab Scandal was born. Hosts Jamie Folk and Ilyas Rona will be exploring the William H Hinton, UMass Amherst and State Police crime labs associated with this scandal and speak with the la ...
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Newsworthy OIG Work Plan for November 2025, Trusty Tip on Chronic Care Management, and Edmund Hillary's Spark
23:21
23:21
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23:21Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 15 features a Newsworthy update on the OIG Work Pl…
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Newsworthy Month of Fraud, Waste, and Abuse, Trusty Tip on E/M with Modifier 25, and Winston Churchill's Spark
36:12
36:12
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36:12Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot. Sonal's 16th Season starts up and Episode 17 features Newsworthy updates on the mont…
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Newsworthy PEPPER is Back, Trusty Tip on Skin Substitute LCDs, and Thomas Edison's Spark
15:48
15:48
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15:48Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 16 features a Newsworthy update on the PEPPER pr…
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Episode 399 - Ancillary Staff v. Reimbursable Providers - Daily Dose
14:41
14:41
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14:41Summary In this episode, Sean Weiss discusses the complexities surrounding ancillary providers and their billing practices, particularly focusing on CMS and commercial payer rules. He explains the definitions and roles of ancillary staff, the intricacies of incident to billing, and the compliance requirements for split shared services. The conversa…
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Whistleblower attorney Max Volman will return to the next Monitor Monday broadcast to report the latest news about whistleblowers. As we have learned, often “whistleblowers” are not insiders reporting wrongdoing; they tend to be outside the offending organization. Register now to listen to Max Voldman’s exclusive report. Broadcast segments will als…
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The Fatal Blow: “Statistically Valid Extrapolation”
29:25
29:25
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29:25For years, federal audit contractors have treated statistical extrapolation as the unassailable engine driving massive overpayment demands. The premise sounds reasonable enough: review a small sample of claims, calculate an error rate, and multiply across the entire population to produce a "statistically valid" overpayment figure. In a perfect worl…
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Summary In this episode, Sean M Weiss engages with Richa Kaul, CEO of Compliance with a Y, discussing the critical role of governance, risk, and compliance (GRC) in today's data-driven world. They explore the mission behind the organization, the importance of risk assessments, and the challenges posed by rapid advancements in AI technology. Richa e…
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Newsworthy World AIDS Day, Trusty Tip on New Hospice Outpatient Services Edit, and Marcus Aurelius' Spark
15:03
15:03
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15:03Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot. Sonal's 16th Season starts up and Episode 14 features a Newsworthy update on World A…
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Episode 397 - Daily Dose - The Compliance Officer "The Guardian of Integrity "
19:16
19:16
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19:16Summary In this episode, Sean M Weiss discusses the critical role of compliance officers in healthcare organizations, emphasizing their responsibilities, best practices, and the importance of regulatory compliance. He highlights the need for a proactive approach to risk assessment, the do's and don'ts of compliance, and the necessity of independenc…
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The Feds Blow the Whistle: A $45 Million Wound Care Settlement
31:50
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31:50The False Claims Act (FCA) suit was initiated by the U.S. government, not a traditional whistleblower. Nonetheless, the recent $45 million settlement with a Florida physician and his wound care group – Vohra Wound Physicians Management LLC – resolved allegations that group knowingly submitted claims to Medicare for medically unnecessary yet lucrati…
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Episode 396 - Daily Dose - Building a Culture of Compliance
18:53
18:53
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18:53Summary In this episode of the Compliance Guy podcast, Sean M Weiss reflects on the challenges and lessons learned in 2025 regarding compliance in healthcare. He emphasizes the importance of building a robust culture of compliance to prepare for the upcoming year, 2026, which is expected to bring increased scrutiny from federal agencies. Weiss outl…
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Newsworthy Month of Fraud, Waste, and Abuse, Trusty Tip on Medicare Telehealth Update, and Dalai Lama's Spark
29:31
29:31
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29:31Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot. Sonal's 16th Season starts up and Episode 13 features Newsworthy updates on the month'…
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Episode 395 - #TerryTuesday - Understanding Revenue Cycle Management
26:19
26:19
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26:19Summary In this episode, Sean M Weiss and Terry Fletcher discuss the complexities of compliance in healthcare, particularly as the year comes to a close. They explore the importance of understanding revenue cycle management, the disconnect between clinical and payer policies, and the necessity of reading contracts thoroughly. The conversation empha…
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Providers Appear More Aggressive in Defending Revenue
27:44
27:44
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27:44It’s raining RACs. And many other third party auditors. It seems like every submission of medical records is being scrutinized for omission and commission. Then enter artificial intelligence (AI). The use of AI in auditing, although relatively new, is here to stay. How is your facility faring compared to your peers? More audits? Less auditing? More…
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Episode 394 - USA v Raj - The Trial That Changed Everything
42:22
42:22
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42:22Summary In this episode of the Compliance Guy podcast, Sean M Weiss interviews Dr. Raj Bothra, who shares his harrowing experience of being wrongfully accused of Medicare fraud and excessive narcotics distribution. Dr. Bothra discusses the complexities of the case, the role of the DOJ and FBI, and the injustices he faced during his trial. He emphas…
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Newsworthy 2025 RAC Audits, Trusty Tip on 2025 RAC Audits, and Isabel Allende's Spark
16:24
16:24
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16:24Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 12 features a Newsworthy update on RAC audits for …
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New Audit Traps Revealed in the 2026 Medicare Physician Fee Schedule
28:24
28:24
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28:24The Centers for Medicare & Medicaid Services (CMS) recently released the 2026 Medicare Physician Fee Schedule. And while that’s not breaking news, the important news is that you and your team could benefit by understanding its hidden traps – so you can protect your revenue. During the next live edition of Monitor Monday, senior healthcare analyst F…
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Newsworthy OIG Work Plan for October 2025, Trusty Tip on Claims Processing Update, and Ernest Hemingway's Spark
18:24
18:24
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18:24Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 11 features a Newsworthy update on the OIG Work Plan…
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Episode 393 - Medicare Advantage and Your Obligation to Comply - #TerryTuesday
31:42
31:42
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31:42Summary In this episode, Sean M Weiss and Terry Fletcher discuss the complexities surrounding Additional Documentation Requests (ADRs) from Medicare Advantage plans. They emphasize the importance of compliance, the legal obligations of providers, and the potential consequences of ignoring these requests. The conversation also touches on the ongoing…
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New Sepsis Definition Could Help You Achieve Denial Avoidance
30:12
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30:12Recently, a new version of the Sequential Organ Failure Assessment (SOFA) score was introduced. Known as SOFA-2, this new definition aligns with organ dysfunction measurement in critically ill adults with current clinical practices, especially those diagnosed with sepsis. Published in the Journal of the American Medical Association (JAMA) on Oct. 2…
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Episode 392 - The Real Role of The Compliance Officer - Daily Dose
17:27
17:27
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17:27Summary In this episode, Sean M Weiss discusses the critical role of compliance officers in healthcare organizations, emphasizing their responsibilities, best practices, and the importance of maintaining objectivity and independence. He outlines the do's and don'ts of compliance, highlights essential resources for compliance officers, and stresses …
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Newsworthy Lung Cancer Awareness Month, Trusty Tip on CY 2026 MPFS Final Rule on Telehealth, and Margaret Thatcher's Spark
19:06
19:06
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19:06Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 10 feature…
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Episode 391 - #TerryTuesday - Getting It Right
34:03
34:03
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34:03Summary In this conversation, Terry Fletcher and Sean M Weiss discuss the recent announcement by ChatGPT regarding its decision to cease providing health and legal advice due to a significant error rate. They explore the implications of this decision, the ongoing debate about the accuracy of AI chatbots, and the potential consequences of AI errors …
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DME Supplier Pays $37 Million to Resolve FCA Allegations
30:12
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30:12Durable medical equipment (DME) supplier Semler Scientific Inc., along with a former distributor, Bard Peripheral Vascular Inc. and its related companies, have agreed to pay $37 million to resolve allegations that they violated the False Claims Act (FCA) by knowingly causing and conspiring to cause the submission of false claims to Medicare for pho…
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Episode -390 - Summer McKeivier - The Complexities of Healthcare Law
1:04:08
1:04:08
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1:04:08Summary In this episode of The Compliance Guy podcast, Sean M Weiss engages in a detailed conversation with attorney Summer McKeivier about the complexities of healthcare law, particularly focusing on incident two billing, healthcare fraud prosecutions, and the challenges faced by providers in navigating compliance issues. They discuss the current …
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Newsworthy Month of Fraud, Waste, and Abuse, Trusty Tip on Family History of Breast Cancer, and Maya Angelou's Spark
16:57
16:57
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16:57Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 9 features N…
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Episode 388 - Don Self - Complexities of Medical Billing
41:37
41:37
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41:37Summary In this episode of the Compliance Guy podcast, Sean M Weiss welcomes Don Self, a veteran in the medical billing industry, to discuss his extensive experience and insights. They explore Don's two recent books, touching on topics such as medical office management, evaluation and management services, and the importance of understanding ERISA. …
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A New Drug Crisis Soon Facing American Hospitals
31:09
31:09
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31:09America’s hospitals will soon face an unprecedented rebate-based prescription drug model, come Jan. 1 – that’s when there will be as many as 10 major drugs subject to Medicare price caps. This development is expected to create administrative and financial challenges for hospitals, which will have to pay the commercial price for such drugs while wai…
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Episode 387 - Steven Adler - Noncompete and Restrictive Covenants
46:35
46:35
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46:35Summary In this episode of The Compliance Guy podcast, Sean M Weiss interviews Steven Adler, co-chair of litigation at Mandelbaum Barrett PC, focusing on non-compete agreements and restrictive covenants in healthcare. They discuss the complexities of these agreements, the rights of patients, and the implications of a recent case involving Dr. Timot…
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Newsworthy Claims Hold, Trusty Tip on PNB Biopsies, and Marianne Williamson's Spark
15:38
15:38
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15:38Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 8 features a New…
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Episode 386 - #TerryTuesday - Advancing Your Healthcare Career
31:55
31:55
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31:55Summary In this engaging conversation, Sean M Weiss and Terry Fletcher explore the evolving landscape of healthcare in 2025, emphasizing the importance of reflection on career paths, the integration of AI in healthcare, and the vast opportunities available within the industry. They discuss the significance of passion in one's career and the need fo…
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This marks the third week of the federal government shutdown: an epic failure of congressional leaders from both political parties who couldn’t agree on how fund the government for the fiscal year that began Oct. 1. And now many experts inside and outside of government believe this could be the longest shut down in history, surpassing the previous …
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Episode 385 - #TerryTuesday - The Future of Telehealth
24:36
24:36
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24:36Summary In this episode, Sean M Weiss and Terry Fletcher discuss the current state of telehealth services amidst the ongoing government shutdown. They explore the changes in telehealth regulations since the public health emergency, the challenges faced by Medicare in reimbursing telehealth services, and the implications of the False Claims Act for …
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RIGGEDLabs UNRIGGED! Podcast | S3 E2 -Justin Volk Case Overview
45:27
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45:27Welcome to RIGGEDLabs UNRIGGED! Podcast | Season 3 Episode 2. In this episode we will review the case of San Francisco lab analyst Justin Volk. Season 3 of RIGGEDLabs Podcast—hosted by investigative journalist Jamie Folk and attorney Ilyas Rona, premieres on November 1, 2025, with weekly episodes available on all major podcast and social platforms …
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RIGGEDLabs Podcast | Season 3 Press Release - Introduce and Read by Jamie Folk
11:26
11:26
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11:26In this first episode of RIGGEDLabs Podcast Season 3, Jamie Folk introduces a new season and reads the new press release. - RIGGEDLabs SEASON 3 PRESS RELEASE Contact Information: RIGGED: RIGGED Lab Massachusetts Podcast Mr. Jamie Folk +1-774-291-9493 | Phone [email protected] | email Release Date: October 10, 2025 FOR IMMEDIATE RELEASE Retu…
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Newsworthy Breast Cancer Awareness Month, Trusty Tip on FNA Biopsies, and Elie Wiesel's Spark
16:23
16:23
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16:23Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 7 features a Newsw…
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During Case Management Week: Unpacking Healthcare Cuts
59:14
59:14
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59:14You’re invited to go behind the scenes and listen as case managers tell their stories – of long hours, little sleep, and always being ambushed by a bell ringing for help. These unsung heroes of healthcare are receiving their moment in the sun during the next live edition of Monitor Mondays, with a special 60-minute broadcast. The first half of the …
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Newsworthy OIG Work Plan for September 2025, Trusty Tip on E/M Scrutiny Part III, and Madeleine L'Engle's Spark
11:54
11:54
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By Frank Cohen, MPA | Adam Brenman | Knicole Emanuel, Esq. | David Glaser, Esq. | Ronald Hirsch FACP
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Easy Fixes! Keeping Gov't Going, Safer Mail Delivery, Live Taps at Military Funerals
8:47
8:47
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8:47This is a bit longer than my last podcast ie. "Don't Pay China, Use that Money to Prevent US Shut Down. Visit nUSPS.com and ImpeachthePres.com Facebook.com/StateoftheUSPS My youtube page was deleted when I connected DeJoy to boEing part supplies and was going to connect with Whistleblower John Barnett who was found dead. RIP but it was YouTube.com/…
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Keep Gov't Open with Moeney MArked for China; create our own TikTok (PicPocketUSA) using Laid Off Engineers and AI
4:07
4:07
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4:07Ask yourselves... WHY would T'rump want to GIVE China money? Reimbursement for Tariffs paid to the USA? (562)804-5625 KaRi from ThePrimeSpot.com nUSPS.com ImpeachthePres.com URL is For Sale but see where it leads!
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Newsworthy ICD10CM for 2026, Trusty Tip on Telehealth Today, and Nelson Mandela's Spark
22:36
22:36
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22:36Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 5 features…
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Episode 384 - #TerryTuesday - What The Healthcare (WTH) - Navigating CDI
24:31
24:31
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24:31Summary In this episode, Sean M Weiss and Terry Fletcher discuss the critical aspects of Clinical Documentation Integrity (CDI) in healthcare. They explore the importance of compliance, the implications of audits, and the responsibilities of providers in maintaining accurate medical records. The conversation highlights the need for integrity in doc…
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Episode 383 - Monday Auditing, Coding and Compliance Roundtable
1:02:37
1:02:37
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1:02:37I was joined by Terry, Stephanie, Scott, Paul and Christine for this all new episode to discuss a variety of issues including tied to Auditing, Coding, Compliance, and Documentation. I was so good to be back after a 3-week break to spend time with the panel and with all of our listeners/viewers and friends!…
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Into a Rabbit Hole: Medical Loss Ratio Fraud Detected in Managed Care Program
28:55
28:55
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28:55A 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 involves millions of dollars of potential fraud, it quickly becomes a large blip on the government’s fraud de…
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Newsworthy Month of Fraud, Waste, and Abuse, Trusty Tip on E/M Scrutiny Part II, and Mary Anne Radmacher's Spark
26:56
26:56
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26:56Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 4 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 4 features New…
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Whistleblowers Bring Total Knee Replacement DME to its Knees
28:14
28:14
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28:14Three 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 million to resolve alleged violations of provisions of the False Claims Act (FCA). Famed whistleblower attorney Mar…
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Newsworthy Suicide Prevention Awareness Month, Trusty Tip on Orthopedic Footwear, and Robert F. Kennedy's Spark
15:34
15:34
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15:34Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 5 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 16th Season starts up and Episode 3 features a…
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Highlights of VA OIG's Oversight Work from August
5:22
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5:22Each month, the VA Office of Inspector General publishes highlights of our oversight reports, congressional testimony, and investigative work. In August 2025, the VA OIG published 17 reports that included 72 recommendations to VA. Report topics included a review of medical facilities in VISN 12 (VA Great Lakes Health Care System) and whether they c…
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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 signal fraud. The U.S. Department of Justice (DOJ) logged 979 qui tam cases in 2024, many of which were reportedl…
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