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Tune in to 1st Talk Compliance with your host, Catherine Short, Partnership Marketing Specialist at First Healthcare Compliance. On this 30-minute, informative program, Catherine, and her guests will discuss the hottest topics, pain points and learning opportunities related to healthcare compliance…

1st Talk Compliance


    • Feb 4, 2026 LATEST EPISODE
    • infrequent NEW EPISODES
    • 46m AVG DURATION
    • 466 EPISODES


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    Latest episodes from 1st Talk Compliance

    Telehealth Extensions & 2026 Compliance Priorities: A Compliance Cliffs Update

    Play Episode Listen Later Feb 4, 2026 19:51


    In this episode of 1st Talk Compliance, Kevin Chmura is joined by Robyn Johns, as they discuss recent updates to their November live webinar, Compliance Cliffs: Navigating Telehealth Waivers and Reimbursement Changes. Learn how the policy landscape has shifted in recent months—especially around telehealth flexibilities, controlled substance prescribing, and the 2026 CMS payment rules.   Kevin Chmura Welcome to 1st Talk Compliance. I’m Kevin Chmura, CEO of Panacea Healthcare Solutions. Today we’re bringing you a timely update on our November live webinar, Compliance Cliffs: Navigating Telehealth Waivers and Reimbursement Changes. Since that webinar, several policy changes have moved quickly, especially in telehealth flexibilities. Controlled substance prescribing and 2026 CMS payment rules. Before we jump in, just a quick note. 1st Talk Compliance is brought to you by 1st Healthcare Compliance, a part of Panacea Healthcare Solutions. We help healthcare organizations strengthen their compliance programs with practical education tools and compliance management support. So teams can reduce risk, keep pace with regulatory change and operate with confidence. Now I’m pleased to welcome back Robyn Johns from Med USA. Robyn, thanks for coming back. Robyn Johns Thanks, Kevin. I’m happy to be here. Kevin Chmura  Great. So, let’s jump in. So, in November on the webinar, we spent a lot of time on what people were calling the telehealth cliff, which was creating a tremendous amount of uncertainty on whether flexibilities would expire. Can you catch us up on what the status is now? Robyn Johns  Yeah. The major update is that the spending package released on January 20th includes extensions of the telehealth flexibilities all the way through December 31st of 2027. Kevin Chmura So that’s a pretty meaningful runway. That’s great, but I guess doesn’t eliminate compliance obligations, but it is reducing near-term uncertainty which give everybody some time to standardize workflows. So, it’s in the news, but maybe you could tell. So, what’s in the spending package at a high level and what should healthcare leaders like us be paying attention to? Robyn Johns   Right. So, it was the one from the 20th was a $1.2 trillion spending package released by the House Appropriations Committee and it was just passed yesterday on the 22nd in two separate votes by the full House. So, those bills included the remaining six of the twelve appropriations necessary to avert a government shutdown. So that’s good news for everyone. If we can get them across the finish line, they funded many of the federal government agencies such as HHS, Labor, Defense, HUD, and also Homeland Security. That was a contentious one. That’s why they had to do two separate votes. It funds them through fiscal year 2026, which ends on September 30th of this year. Kevin Chmura  So, OK, so we have a funding package with multiple healthcare policy riders. Not, I guess not too surprising in today’s day and age. So, besides the telehealth through 2027, what else is included in there that compliance and operational leaders should know about? Robyn Johns   So the writers also include PBM reform and it extends hospital at home actually through 2030, which is another one that hit a lot of facilities hard with the government shutdown. It extends Medicare dependent hospital and low volume hospital programs, which is really beneficial for our rural providers and it delays the Medicaid disproportionate share cut again until fiscal year 2028. Notably, for a lot of people, it does not include an extension of the ACA subsidies, which were such a sticking point in the government shutdown last fall. Kevin Chmura  Yeah, that that that last point is operationally really important and coverage instability often turns into eligibility churn and puts real pair mix pressures on the you know same patients, different coverage, right.? And that’s just you know probably increases downstream compliance and documentation stress. Yeah that’s a that’s a tough one. So what’s the timing of congressional action now? Robyn Johns So with the House passing all of the bills, they now send the full appropriations package to the Senate. The Senate will take all of that up when they return from recess on Monday the 26th, and will hopefully pass them all ahead of the January 30th deadline. And hopefully without any significant changes which might require them to go back to the house because the house will be on recess next week. Kevin Chmura  Wow. So split schedule, it’s why we should keep ourselves in a monitoring posture. I guess we should always be monitoring, but things are moving pretty quickly right now and you sort of get into that world of what is expected is not what’s in effect. Which is always, always a tough place to operate, but hey, that’s healthcare, isn’t it? So, given the extension to 2027, in your opinion, what should compliance teams be doing now? Like what’s some practical next steps? Robyn Johns First, you’ll want to make sure that your internal policies and educational materials reflect what’s currently in effect. No major changes since most of those telehealth things were extended, but it’s always good to double check because lots of things change around the beginning of the year. Also validate your payer specific rules. Medicare policy direction is influential, but commercial payers and state laws differ. So, you got to make sure that you are matching up with those differences. And then third, we should we talk about strengthening your auditing of documentation, the modifiers, your place of service, medical necessity, all of those things that can vary depending on the payer and the specific situation of the patient. Kevin Chmura  Yeah, that that payer variation point is where a lot of organizations end up being exposed, I guess, right? Telehealth’s not really governed by one rule. You’ve got federal policy, state overlays, and then you have commercial policy updates really coming at you a number of different ways. So, I guess a good controls to maintain maybe a payer policy matrix and try to align it into your documentation and coding guidance. Probably a solid piece of advice. Robyn Johns   Absolutely. Kevin Chmura   Yeah. So, let’s move on to probably one of the highest risk areas that we covered in the webinar, and that’s controlled substance prescribing via telehealth. What’s the latest there? Robyn Johns   Good news there as well. At the end of the year, DEA and HHS extended the telehealth flexibilities for prescribing controlled substances through this year, December 31st of 2026. There are a few rules that can apply, but because they extended the flexibilities, it’s pretty much status quo until they change it again at the end of the year. Kevin Chmura   Cool, so that’s a critical compliance area because of the high risk profile and it that really includes some regulatory scrutiny and enforcement, not really just a reimbursement issue. Robyn Johns   Yes, it’s highly watched. Kevin Chmura   Yeah. And I guess as well, it should be. So given that, what control should organizations prioritize right now to reduce risk in that area? Robyn Johns  Definitely you’ll want to have clear prescribing policies, good documentation standards, and role-based training. Also, usually they want to include identity verification and required checks when they’re applicable, and consistent auditing to ensure that your process is followed, not just written down. This is another area where state regulations can vary, so you would want to make sure that you are compliant in every state where you see patients. Kevin Chmura   Yes and you’re the expert, not me. But I guess I’d add if you expand health to if you expand the telehealth quickly, take time now to ensure your governance is mature. And I’m thinking credentialing, supervision, documentation and audit trails always the basics that can help you pulled up under scrutiny. Robyn Johns   Definitely. When you expand quickly, sometimes you sacrifice certain things for speed. So, you have a minute now to go back now that you’re sure that those policies aren’t changing anytime soon to just go back and make sure that everything’s in place, all of those areas. Kevin Chmura  Yeah, I mean like any business runs better and with certainty, but at healthcare we rarely have that. So, great. So, moving on to the 2026 CMS updates that that we talked about a little bit. So, there’s been some changes in payment policy that are driving operational changes and it’s where those operational changes come in, where we introduce compliance risks if teams can’t keep pace and often they can’t. So, what are the 2026 physician fee schedule highlights? Robyn Johns   Yeah. So, we talked about these back in November and of course they went into place at the beginning of this year. So, a little bit of good news there with the conversion factor. It included the 2.5% increase that had been mandated by Congress. It also included a .75% increase for clinicians in advanced APMs or a .25% increase for clinicians who participate in MIPS or who are exempt. And then there was also a .49 budget neutrality increase. Kevin Chmura So, so the real impact varies by payer mix, site of service and quality of participation. What about RVU related changes? Robyn Johns   So that’s kind of the devil in the details there. It also implemented a -2.5% efficiency adjustment on certain non-time based services to the physician work RVU and there is also a + or -50% practice expense RVU adjustment for facility based services. So, it’s -50% if it’s facility based services or a +50% for non-facility based services. Kevin Chmura   Wow. So site of service is increasingly strategic and it’s where we see compliance issues often arise, right? You get inconsistent documentation, coding and policy adoptions across different departments and locations. Certainly not easy. Robyn Johns   No. Something you definitely need to watch closely because it is different depending on where you are and what services you’re providing. Kevin Chmura   Yeah. So, one other hotspot or another hotspot that that we often see is incident to. What's going on there? Robyn Johns  So the physician fee schedule in that they updated the definition of direct supervision for incident to billing to permanently allow supervision through real-time audio video communication except for services that have a 10 or a 90-day global surgery period. So, the supervising physician no longer has to be physically present in the office suite, they just have to be immediately available through real time audio video communication. Kevin Chmura   OK, so that’s operationally pretty significant, right? But I guess the compliance take away is relatively simple. If you’re using remote supervision, your incident to workflows must be precise. I guess who supervises, how it’s documented, and where the exceptions apply as precise as you can make all of those, huh? Robyn Johns   Yes, absolutely. Because you are relying on remote supervision, you’ll want to make sure that that is documented very effectively. Kevin Chmura   Yeah, cool. So, what about the OPPS and ASC final rule highlights for 2026? Robyn Johns Yeah. For those that these apply to, there was a 2.6% increase as well in the payment rates. They also expanded hospital price transparency requirements and we’re seeing a lot more attention and probably enforcement in that as well. There was a three-year phase out of the inpatient only list. Site neutral payments were expanded to include Drug Administration Services and the ASC covered procedures list is expanded much in relation to the inpatient only list Phase out. Kevin Chmura Yeah, that that that that’s an interesting one. So the phase out of the inpatient only list is a real operational shift and it’s one of those opportunities for providers to move volume to better cost locations, but really your compliance needs to follow those patients, right and where you’re having them. And so, when your volume moves, audits and education have to move with it, which is probably a challenge and what we know and we at our parent company, at Panacea, price transparency just remains a compliance and reputational priority because failures lead to penalties, but bad data also leads to a lot of scrutiny. So, good that there’s some, you know some guidance there, but it’s clear that those are going to be things that really need to be paid attention to from a compliance perspective. Robyn Johns Yes, for sure. Kevin Chmura So it was hard to watch the news over the last, I don’t know, six to twelve months without talking about the One Big Beautiful Bill Act. So, we’ve been tracking it. I know you’ve been tracking it. So, what’s the timing on practice impacts that you expect? Robyn Johns So most of those One Big Beautiful Bill Act Medicaid requirements that are likely to impact practices, they don’t actually begin until January of 2027. So, practices still have some time to continue their assessment and preparation for those. The immigrant eligibility changes do take effect on October 1st of this year, 2026. So that’s a little bit shorter period of time, but you do have a little bit of time to continue to figure out how that may affect your practice if you have a high number of Medicaid patients, and prepare for the ways that you can offset those eligibility changes and payment requirements. Kevin Chmura Yeah, that clarity on the effective dates really can help teams allocate resources correctly and that’s often a challenge especially when you’re tracking proposed rules versus final rules and not sure when things will go into effect. So that’s good. So, as you’re looking out on the landscape in 2026, what are some of your top compliance priorities that you’re advising organizations to focus on? Robyn Johns Yeah, we’re currently focused on probably five or so top priorities for 2026, not in any specific order, but we are watching data privacy and security. Part of that is because HIPAA updates are underway to both the privacy and security rules, though timelines are unclear. We’re not sure when or i f we’ll see any final rules on those, but we do know that healthcare remains a prime target of cyber-attacks, so we have to constantly be vigilant to that and related to that, but also separately, is AI and other emerging technologies. AI is changing the landscape for the types of attacks we receive, but also the way we have to respond to them. It also is changing the landscape of healthcare generally, both in the provider office and at the payers and at the government. Those other emerging technologies like digital tools, those can increase the compliance risk in your environment, and we need to remember that both government and commercial payers are using AI to identify outlier claims faster and increase their auditing. Then we also have the fraud, waste and abuse enforcement. CMS we know has currently been focused a lot on Medicare Advantage, but that scrutiny can shift oversight over to providers as well because that’s where so much of the data that the Medicare Advantage plans use comes from. The OID also continues to focus on telehealth. There are other focuses are drug device and biologics and program integrity areas such as DME, Hospice and Drug Administration. So, want to make sure that you’re watching all of those if you practice there. Fourth one we have is vendor and third-party oversight. Many of the largest breaches that have we’ve seen have originated with third parties. So, organizations really need to make sure that you have careful oversight and maintain good monitoring on your third-party vendors and others who may have access to your systems and data. And finally, we know we’re going to continue to see those rapid regulatory updates. Federal and state changes often conflict. We have lots of states that are currently in their legislative period. So that will bring out some changes. And then in addition to that, commercial payers are tightening their policies and auditing in response to the pressures that are being put on that on them, whether from the government or just from a financial perspective. Kevin Chmura Yeah, it is something the pace of acceleration of some of the advances in technology and how they how they’re going to impact us. But I guess you know that’s really the reality of 2026 and beyond. You’re going to see an uptick in in in speed to policy changes, faster detection, which will be something and probably more third-party exposure as we rely on more and more vendors and others to help us do what we need to do every day, but I’m sure you know the advice I’ve heard you give many times and we have to agree with it. A strong compliance program has to be built to adapt. That means clear governance, repeatable monitoring and targeted auditing tied to the current risk with an eye on the future and where everything’s going. Robyn Johns Yeah, definitely. It’s an exciting time, lots of opportunities for improving our programs and really tightening things up to make sure that we’re protecting ourselves and all the information that we are responsible for. Kevin Chmura Yeah, great. So, Robyn, thank you for the update and for helping our listeners translate policy movement into practical compliance actions. To everyone listening, if you want the full context and deeper discussion, you can access the webinar on demand at 1st Healthcare Compliance’s website. It’s called Compliance Cliffs: Navigating Telehealth Waivers and Reimbursement Changes. Thank you for listening to 1st Talk Compliance and we’ll see you next time. Thanks, Robyn. Robyn Johns Thanks, Kevin.

    Update to the HIPAA Privacy Rule to Support Reproductive Healthcare Privacy Compliance

    Play Episode Listen Later Jul 14, 2025 33:21


    In this episode of 1st Talk Compliance, Kevin Chmura is joined by Rachel Rose, JD, MBA, as they discuss recent changes to the HIPAA Privacy Rule to Support Reproductive Health Care and Privacy in relation to recent court rulings. This rule, which went into effect in April of 2024, still has certain components which practices need to know about and adhere to heading into 2026.

    The Role of Compliance Programs in Mitigating False Claims Act Liability

    Play Episode Listen Later Jun 11, 2025 36:11


    In this episode of 1st Talk Compliance, Kevin Chmura is joined by Rachel Rose, JD, MBA, as they discuss the False Claims Act in detail. The FCA, one of five federal laws built to combat fraud, waste, and abuse, is the government's primary fraud fighting tool, with the healthcare industry paying the largest contributor in recoveries for over a decade. Learn not only about how to avoid running afoul of this law, but also some details of cases in which it was violated, and the repercussions those who did so faced. In addition, find out how a proper compliance program can protect your practice in various ways, including staying up to date on cybersecurity training. Kevin Chmura Rachel, welcome to the podcast. Thanks for joining us.   Rachel V. Rose Thank you, Kevin, for having me back for another round of a very major healthcare compliance topic.   Kevin Chmura It very much is, yeah. This one generates some revenue for the government. So this is one that I think especially in today's environment, people should be paying a lot of attention to. So as I said in the intro, we're here to talk about the False Claims Act. It's one of the most important fraud, waste and abuse laws that applies to physicians and health care practitioners of all kinds. The healthcare industry has consistently been one of the, if not the highest contributor to funds received under the False Claims Act. And it's essential to be familiar with the law and maintain compliance programs to mitigate that risk. Rachel, I know you spend a fair amount of time in your practice in and around the False Claims Act defending and representing customers and providers. So you're perfect to cover this topic for us. Wondering, though, if you could give us a brief synopsis of the False Claims Act and why is it unique?   Rachel V. Rose Absolutely. So as you mentioned, my practice focuses a lot on the False Claims Act, and I am fortunate to do a lot of compliance work not only around the False Claims Act, but HHS. OIG has identified five important federal fraud, waste and abuse laws. The False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Authorities, and the Civil Monetary Penalties. And Kevin, as you mentioned, the False Claims Act is really the federal government's primary fraud fighting tool. And in 2024, there were more than $2.9 billion in recoveries and, moreso healthcare represented over two thirds of that amount. That healthcare trend, as you mentioned, being the largest contributor, has gone on for at least the last decade. And what the False Claims Act does that makes it unique are really, I would say, five main things. But first, the False Claims Act goes back to 1863, and it is also known as the Lincoln Law. Its primary purpose, even back during the Civil War, was to root out fraud that was being perpetrated on the government. So how would that be done? Congress thought about it and said, well, the government could do it on its own if they caught wind of something, or they could insert a provision which gave an individual known as a relator, also known as a whistleblower, the potential to bring fraud to the government's attention and receive a portion of the recovery. It's very important to note that a relator and I represented several relators successfully, sometimes with co-counsel, sometimes with not, so I get to see the False Claims Act from the whistleblower standpoint as well. But this notion of being able to represent a whistleblower is the first distinguishing factor. And that's because most other civil cases, a person can represent themselves on a pro say basis, meaning they don't need a lawyer. There was a provision in the False Claims Act which in fact requires an individual to be represented by a lawyer. So unless the relator is a lawyer, then the individual needs to obtain counsel in order to file a False Claims Act case. That's the first thing. Secondly,

    HIPAA Privacy Rule to Support Reproductive Healthcare Privacy Compliance

    Play Episode Listen Later May 12, 2025 20:10


    In this episode of 1st Talk Compliance, Kevin Chmura is joined by Rachel Rose, JD, MBA, to discuss the HIPAA Privacy Rule to Support Reproductive Healthcare Privacy, passed in 2024. With the reproductive healthcare landscape being very dynamic, this new rule has already passed one compliance date, with a second important date coming in February 2026. Tune in to learn about this new rule, and what it means in terms of reproductive health, patient privacy, and the legality between different states. In addition, learn some best practices for implementing the requirements of this rule into your practice. Kevin Chmura Rachel, thank you for joining us. Appreciate you joining us and looking forward to a timely discussion.   Rachel V. Rose Thank you, Kevin, for having me, as well as to Panacea and First Healthcare Compliance, it's always my pleasure to coordinate and converse with you on our favorite healthcare compliance topics.   Kevin Chmura And it's always great having you helping us with this and your expertise is invaluable. And you helped us and were the contributor, really writer, of an e-book on this particular subject that will be released very soon. Really this podcast is somewhat of a companion piece to that. And so what we're talking about today is the HIPAA privacy rule to support reproductive health care privacy, passed in 2024. Reproductive health is a prominent and evolving topic within the healthcare policy landscape. It really, major changes have come down in recent years, and so there's just a ton. So we thought it would be great to publish a book to get everybody up to speed and, but moreover, this podcast is an opportunity for people to hear directly from the person who helped us develop that. And that is Rachel. So, Rachel, I wonder, can you just start off by giving us a synopsis of the 2024 Final Rule, maybe some key terms we should be thinking about?   Rachel V. Rose Sure. As you mentioned, Kevin, the reproductive healthcare landscape is very dynamic and the rule itself was issued on April 22nd of 2024 with an effective date of June 25th of 2024. And basically what an effective date does is to start the clock running as to when certain requirements need to be implemented. In this particular rule, which I will refer to as the HIPAA Reproductive Rule, has two prongs of compliance dates. The first already passed and that had to be done by December 23rd, 2024. And for your clients who were with First Healthcare Compliance or Panacea at the time, they were able to access FAQs. And the first prong of the requirements really addressed every applicable item that I'll run through, with the exception of the notice of privacy practices. Now, for anyone who's been in the healthcare sector for a long time, and for anyone who goes to the doctor, a dentist or even a pharmacy to pick something up, we all know we have to sign the HIPAA authorization form, and then covered entities are required to post their notice of privacy practices. So the updated privacy practices, which need to include some of the reproductive health requirements among other items, does not need to be done until February 16 of 2026. So this is similar to the staggering of the compliance dates which we saw with the Final OmnibusRrule, which was published in the Federal Register, it's hard to believe, but going on over 12 years ago and that was January 25th of 2013. Now specifically, the HIPAA reproductive rule really prohibits the disclosure of protected health information related to in these terms I need you to focus on: lawful reproductive health care in certain circumstances. And the reason it's important is because legal means that whatever service or good is being sought, it has to be legal within the jurisdiction where the individual is receiving that care or that good, so to speak. And so if we want to take certain types of surgeries or certain types of procedures that in a viable fetus's lif...

    RE-RELEASE Mastering Defensible Pricing in the Era of Price Transparency

    Play Episode Listen Later Feb 19, 2025 15:55


    In this episode of 1st Talk Compliance, we dive into an increasingly crucial topic in healthcare: price transparency and its ever-growing impact on the industry. Kevin Chmura, CEO at Panacea Healthcare Solutions, joins us to share expert insights on strategic pricing and compliance, emphasizing the transformative benefits for healthcare providers. Learn how to proactively engage with CMS regulations and set your organization apart as an ethical leader in the realm of price transparency.

    RE-RELEASE The Sky’s the Limit: How Price Transparency Can Empower Healthcare Providers

    Play Episode Listen Later Feb 18, 2025 27:19


    Grace Walsh speaks with Kevin Chmura, CEO at Panacea Healthcare Solutions, to explore an extremely timely topic: price transparency and its far-reaching impact on how healthcare providers interact with consumers, with each other, and with the market at large. Tune in as Kevin shares some important insights about how price transparency has opened the door to a whole new world of data analysis and strategic business strategies for healthcare providers, and covers what we might expect to see for the future of price transparency. We'll also include some key resources for listeners hoping to boost their knowledge of CMS price transparency regulations and learn how they can leverage price transparency data to empower their own strategic initiatives.

    New HCPCS Code Requirements for Supplies: Managing Your CDM to Avoid Claim Denials

    Play Episode Listen Later Feb 3, 2025 16:04


    In this episode of 1st Talk Compliance, Kevin Chmura and BreAnn Meadows discuss the challenges healthcare providers face due to payers increasingly denying claims for supplies that are missing HCPCS codes. The issue stems from recent payer policy changes, with supplies that were previously chargeable now being rejected if they lack a corresponding HCPCS code. The conversation tackles the complexities providers face in managing their chargemaster (CDM), maintaining accurate HCPCS coding, and addressing claim denials, which can result in lost revenue. Tune in to equip yourself with actionable strategies to avoid claim denials, as Bre underscores the importance of adopting a strategic, focused approach to managing your CDM, adapting to evolving payer practices, and staying proactive in compliance efforts.

    The Two-Midnight Rule: Navigating the Complexities and Achieving Compliance

    Play Episode Listen Later Jan 8, 2025 18:42


    The Centers for Medicare and Medicaid Services (CMS) recently released additional guidance on the Two-Midnight rule that carries important implications for hospitals seeking to apply the rule correctly and consistently. In this episode of 1st Talk Compliance, host Kevin Chmura is joined by Stacy Pereira, Executive Director of Coding and Clinical Services in Panacea's KA Consulting Division, to continue the discussion surrounding the Two-Midnight rule and the challenges it poses. If you enjoyed Panacea's recent webinar on the topic, or you're simply looking for more information on how the rule might impact you, tune in for a deep dive into the potential challenges involved for hospitals seeking to apply the rule correctly, possible financial impacts of the rule's enforcement, and pitfalls of over- or underusing observation status. In case you missed our webinar on the Two-Midnight rule, you can watch it on-demand here.

    Delivering Innovative Solutions: A Conversation with Panacea's Newest Division President

    Play Episode Listen Later Oct 14, 2024 24:07


    In a landmark episode of 1st Talk Compliance, Kevin Chmura, CEO of Panacea Healthcare Solutions and host of the show, is joined by George Kelley, president of Panacea's KA Consulting Services division. For over 40 years, KA Consulting Services has delivered unmatched revenue cycle solutions, helping hospitals and health systems nationwide enhance reimbursement, improve compliance, and streamline Medicaid eligibility. Known for its eligibility services, clinical coding and auditing services, and revenue integrity solutions, KA Consulting has earned a reputation for providing solutions that go the extra mile to obtain appropriate reimbursement and to improve compliance. We are thrilled to welcome them as a division of Panacea Healthcare Solutions, further enhancing our commitment to delivering industry-leading healthcare financial, revenue integrity, and clinical solutions nationwide. Tune in to get the inside scoop on this latest development as Kevin and George delve into KA's background and our shared history and discuss how our newly combined expertise complements each other's teams.

    The Role of Compliance Programs in Mitigating False Claims Act Liability

    Play Episode Listen Later Jul 26, 2024 61:48


    The False Claims Act—alongside the Anti-Kickback Statute and Stark Law—represents one of the five core fraud, waste, and abuse laws identified by the HHS Office of the Inspector General. Out of the billions of dollars reclaimed through False Claims Act recoveries in 2023, the majority was attributed to the healthcare industry. This concerning trend highlights the importance of maintaining robust compliance programs and prioritizing education surrounding these regulations. In this episode of 1st Talk Compliance, Rachel Rose, JD, MBA discusses recent key developments in the False Claims Act landscape and shares tips on how healthcare providers can enhance their compliance strategies and mitigate regulatory risks. Tune in to gain a comprehensive understanding of the False Claims Act and its role in the healthcare sector, hear updates on several recent significant fraud, waste, and abuse cases, and receive actionable insights into bolstering your organization's compliance initiatives.

    Part 2: The Sky's The Limit – How Price Transparency Can Empower Healthcare Providers

    Play Episode Listen Later Jun 13, 2024


    Previously on First Talk Compliance, we spoke with Kevin Chmura, CEO of Panacea Healthcare Solutions, about how the advent of price transparency has caused the business of healthcare to evolve and opened up fresh possibilities for healthcare providers to gain a competitive advantage. In this episode, we continue that conversation by inviting on two additional experts from Panacea—Govind Goyal, President of Financial Services, and Henry Gutierrez, Senior Vice President, Financial Consulting Services—to dive deeper into the recent changes to price transparency requirements and expand upon the many ways healthcare providers can adapt to succeed in this new consumer-driven arena. From navigating compliance regulations to leveraging data for a competitive advantage, tune into Part 2 of “The Sky's the Limit – How Price Transparency Can Empower Healthcare Providers” to gain insight into the evolving landscape of price transparency and what lies ahead.

    Navigating Private Equity in Healthcare

    Play Episode Listen Later May 2, 2024 28:02


    Private equity has become increasingly entrenched in the healthcare sector, offering various financing options for providers to consider. However, like all types of financing, private equity introduces its own unique set of benefits and drawbacks and carries important legal implications. It's essential to understand all the factors at play in order to maximize financial impact and preserve operational efficiencies while avoiding sacrificing compliance and quality of care. Tune in to hear Grace Walsh in conversation with Rachel Rose, JD, MBA, to explore this timely topic. In addition to providing a detailed overview of private equity in healthcare and its various pros and cons, Rachel shares valuable updates on enforcement actions by the U.S. Department of Justice and Congressional inquiries.

    The Sky’s the Limit: How Price Transparency Can Empower Healthcare Providers

    Play Episode Listen Later Mar 26, 2024 27:19


    Grace Walsh speaks with Kevin Chmura, CEO at Panacea Healthcare Solutions, to explore an extremely timely topic: price transparency and its far-reaching impact on how healthcare providers interact with consumers, with each other, and with the market at large. Tune in as Kevin shares some important insights about how price transparency has opened the door to a whole new world of data analysis and strategic business strategies for healthcare providers, and covers what we might expect to see for the future of price transparency. We'll also include some key resources for listeners hoping to boost their knowledge of CMS price transparency regulations and learn how they can leverage price transparency data to empower their own strategic initiatives.

    The Importance of Defensible Pricing

    Play Episode Listen Later Feb 20, 2024 15:55


    Grace Walsh is joined by Govi Goyal, President of Panacea's Financial Services Division, and Brian Prokop, Senior Vice President of Financial Consulting Services at Panacea, to discuss the importance of undertaking a strategic pricing initiative for your organization. In our current healthcare climate, it's more crucial than ever to maintain defensible and rational healthcare pricing while remaining competitive and optimizing net revenue. As Govi and Brian can tell you, it's a tricky balance to strike. Tune in as they share their tried-and-true approaches to developing defensible pricing strategies and learn how these measures can position hospitals for success in the era of price transparency.

    2024 E/M Updates: What You Need to Know (Extended)

    Play Episode Listen Later Jan 31, 2024 15:55


    Grace Walsh is joined by Becky Jacobsen, Vice President of CDM, Coding & Audit Services at Panacea Healthcare Solutions, to explore the key updates to evaluation and management (E/M) guidelines for 2024. On the surface, this year's changes may appear fairly straightforward, but dig a little deeper and you'll find that the updates have important implications for correct coding procedures. From payers, providers, and coders to those who work in auditing or IT template development, it is essential to keep up a comprehensive grasp on E/M coding guidelines. Tune in as Becky breaks down a few of the most significant guideline updates, clarifies some common areas of confusion, and shares her insider tips as an expert in the field of coding compliance auditing and education.

    2024 E/M Updates: What You Need to Know

    Play Episode Listen Later Jan 22, 2024 15:55


    Grace Walsh is joined by Becky Jacobsen, Vice President of CDM, Coding & Audit Services at Panacea Healthcare Solutions, to explore the key updates to evaluation and management (E/M) guidelines for 2024. On the surface, this year's changes may appear fairly straightforward, but dig a little deeper and you'll find that the updates have important implications for correct coding procedures. From payers, providers, and coders to those who work in auditing or IT template development, it is essential to keep up a comprehensive grasp on E/M coding guidelines. Tune in as Becky breaks down a few of the most significant guideline updates, clarifies some common areas of confusion, and shares her insider tips as an expert in the field of coding compliance auditing and education.

    Mastering Defensible Pricing in the Era of Price Transparency

    Play Episode Listen Later Nov 8, 2023 15:55


    In this episode of 1st Talk Compliance, we dive into an increasingly crucial topic in healthcare: price transparency and its ever-growing impact on the industry. Kevin Chmura, CEO at Panacea Healthcare Solutions, joins us to share expert insights on strategic pricing and compliance, emphasizing the transformative benefits for healthcare providers. Learn how to proactively engage with CMS regulations and set your organization apart as an ethical leader in the realm of price transparency.

    The Increasing Role of the FTC in the Poaching of PHI – A Discussion of Better Help, GoodRx & Flo: Audio Version of the Webinar

    Play Episode Listen Later Jun 8, 2023 53:30


    Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX will be presenting this informative webinar. Cybersecurity risk management and the potential for enforcement actions is not diminishing. An area of increasing interest by the Federal Trade Commission, the United States Department of Justice, and Congress is third parties taking sensitive data (especially by social media and search engine giants), including protected health information, without obtaining affirmative patient/consumer consent and benefiting financially. The U. S. Department of Health and Human Services, the agency tasked with enforcing HIPAA, also plays a critical role. The purpose of this presentation is to address different federal government initiatives, recent enforcement actions and incidents, and risk mitigation.

    Evolution of Price Transparency and How to Stay Ahead of CMS Requirements

    Play Episode Listen Later Jun 7, 2023 28:05


    1st Talk Compliance features guest Govi Goyal, President, Financial Services, at Panacea Healthcare Solutions, on the topic of Evolution of Price Transparency and How to Stay Ahead of CMS Requirements. Govi joins our host Catherine Short to discuss how the new CMS Price Transparency Rule and No Surprises Act are closely related. By providing Good Faith Estimates for healthcare services, hospitals can comply with both regulations. This helps patients understand their expected costs upfront and avoid surprise medical bills. Panacea's CMS Price Transparency and Hospital Zero-Base Pricing software solutions can assist hospitals in providing accurate Good Faith Estimates to their patients and stay compliant with the latest regulations. 

    Healthcare Assets – How to Preserve and Protect

    Play Episode Listen Later May 30, 2023 27:56


    1st Talk Compliance features attorneys Sean McKenna, Lauren Nelson, and Vincent Aiello of Spencer Fane LLP, on the topic of Healthcare Assets: How to Preserve and Protect. We will discuss the interplay between enforcement and liability proceedings with asset protection, explore how government and private litigation matters can impact healthcare companies, clinicians, and executives, and provide tips and preventative strategies to preserve income and assets prior to such action to ensure business continuity and succession planning. 

    A Harassment-Free Workplace vs the Right to Engage in Concerted Activity

    Play Episode Listen Later May 8, 2023 29:05


    1st Talk Compliance features guest Lauren Moak Russell, Counsel at Young Conaway Stargatt & Taylor, LLP in Wilmington, Delaware, on the topic of “A Harassment-Free Workplace vs the Right to Engage in Concerted Activity.” Lauren joins our host Catherine Short to discuss how the National Labor Relations Board under the Biden Administration has expressed a renewed interest in expanding its influence into non-unionized work forces. This includes reviewing and--in the right circumstances challenging--employers' use of workplace civility, confidentiality, and anti-harassment policies. Listen as we discuss what you need to know to safely navigate the National Labor Relations Act while ensuring that your employees enjoy a safe and respectful work environment.

    False Claims Act “Hot Areas” – What You Need to Know: Audio Version of the Webinar

    Play Episode Listen Later Apr 18, 2023 65:08


    Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us through current trends and tips. With its roots stemming back to 1863, the False Claims Act continues to be the U.S. Department of Justice's primary enforcement tool for returning money to the Federal Treasury. It is also considered one of five fundamental fraud, waste, and abuse laws, which potentially impact a provider every time a claim is submitted to Medicare, Medicaid, and other government programs because of the attestation language. The purpose of this webinar is to provide a synopsis of the False Claims Act and the current landscape in relation to coverage determinations and the federal Anti-Kickback Statute.

    False Claims Act “Hot Areas” – What You Need to Know: Audio Version of the Webinar

    Play Episode Listen Later Apr 18, 2023 65:08


    Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us through current trends and tips. With its roots stemming back to 1863, the False Claims Act continues to be the U.S. Department of Justice's primary enforcement tool for returning money to the Federal Treasury. It is also considered one of five fundamental fraud, waste, and abuse laws, which potentially impact a provider every time a claim is submitted to Medicare, Medicaid, and other government programs because of the attestation language. The purpose of this webinar is to provide a synopsis of the False Claims Act and the current landscape in relation to coverage determinations and the federal Anti-Kickback Statute.

    A Practical Approach to The Safe Harbor Law

    Play Episode Listen Later Apr 10, 2023 28:22


    1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of A Practical Approach to The Safe Harbor Law. Ray joins our host Catherine Short to discuss how HIPAA data breach penalties typically get measured in millions of dollars, even following an organization implementing NIST cybersecurity framework measures. However, with the new HIPAA Safe Harbor Law, signed in January 2021, HHS and OCR may consider some penalty mitigation. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe harbor and only offers some protection. This episode will examine what the established security practices for healthcare are, and how to pivot your organization's security profile to mitigate breach penalties if an event occurs. Catherine Short 0:01 Welcome, and let's, 1st Talk Compliance. I'm Catherine Short, Marketing Manager for First Healthcare Compliance, a division of Panacea Healthcare Solutions. Thanks for tuning in. This show is brought to you by First Healthcare Compliance as part of our commitment to provide high quality complimentary educational resources. Please show your support by taking a moment to provide a review on Google, Facebook, or iTunes, and be sure to follow us on social media and subscribe to our YouTube channel. On today's episode, we are speaking with Raymond Ribble, CEO and Founder at SPHER Inc, on the topic of A Practical Approach to The Safe Harbor Law. HIPAA data breach penalties typically get measured in millions of dollars even following an organization implementing NIST cybersecurity framework measures. However, with the new HIPAA Safe Harbor Law signed in January 2021, HHS and OCR may consider some penalty mitigation, it is important to understand that the Safe Harbor Law while offering substantial protection does not provide a true Safe Harbor and only offers some protection. This episode will examine what the established security practices for healthcare are, and how to pivot your organization's security profile to mitigate breach penalties if an event occurs.   Catherine Short 1:39 So Ray, thank you so much for joining me on 1st Talk Compliance. It's a pleasure to have you on.   Raymond Ribble 1:42 Thank you for having me, I appreciate it.   Catherine Short 1:43 Again, I'm so happy you're here today. Today we're discussing about the Safe Harbor Law and we're going to be talking about a practical approach. For people who are new to this, can you give us a good background or a brief description about what we are going to be discussing as far as some compliance background? Or how we got here as far as I know that HIPAA has a Safe Harbor Law? And I know that that affects how people need to protect their health data and their data in general. Can you give us a little bit of background of what we should be protecting and what we should be careful of and what we should be discussing?   Raymond Ribble 2:27 Sure. For our listeners, I'll try to give you the cliff note version of what it is. What I wanted to do for everybody who's listening today is just give you a brief introduction to what is the Safe Harbor Law. I don't want you to become experts on the Safe Harbor Law, I don't want you to be able to click off the five things that it does. That's not the background. It's just that some well thought politicians in both the Senate and the House got together and said, Hey, look, we've provided all this money to help these medical institutions move from paper to digital. In doing so, we've exposed them to a brand new set of risks in terms of data breaches that can occur that didn't exist before. And now we're asking them to spend more money to implement policies and procedures and potentially technology solutions in order to protect that digital data. So that's the first part of it. And they said look, for the organizations that embrace these ideas that go the ex...

    A Practical Approach to The Safe Harbor Law

    Play Episode Listen Later Apr 10, 2023 28:22


    1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of A "Practical Approach to The Safe Harbor Law." Ray joins our host Catherine Short to discuss how HIPAA data breach penalties typically get measured in millions of dollars, even following an organization implementing NIST cybersecurity framework measures. However, with the new HIPAA Safe Harbor Law, signed in January 2021, HHS and OCR may consider some penalty mitigation. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe harbor and only offers some protection. This episode will examine what the established security practices for healthcare are, and how to pivot your organization's security profile to mitigate breach penalties if an event occurs.

    The Safe Harbor Law: A Practical Approach – Audio Version of the Webinar

    Play Episode Listen Later Mar 14, 2023 61:47


    Raymond Ribble is the CEO and Founder at SPHER, Inc. HIPAA data breach penalties typically get measured in millions of dollars even following an organization implementing NIST cybersecurity framework measures. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe harbor. Our presentation will examine what are the established security practices for healthcare, and how to pivot your organization's security profile in order to mitigate breach penalties in the event of an event.

    The Safe Harbor Law: A Practical Approach – Audio Version of the Webinar

    Play Episode Listen Later Mar 14, 2023 61:47


    Raymond Ribble is the CEO and Founder at SPHER, Inc. HIPAA data breach penalties typically get measured in millions of dollars even following an organization implementing NIST cybersecurity framework measures. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe harbor. Our presentation will examine what are the established security practices for healthcare, and how to pivot your organization's security profile in order to mitigate breach penalties in the event of an event.

    The Risk of Data Sharing

    Play Episode Listen Later Mar 13, 2023 23:44


    1st Talk Compliance features guest Iliana L. Peters, Shareholder at Polsinelli PC, on the topic of The Risk of Data Sharing. Iliana joins our host Catherine Short to discuss how these days, health data is an incredibly valuable commodity. Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. In this episode, we will be discussing the scope and breadth of data sharing projects in development in the health care sector, examine contractual, state, federal, and international legal obligations for data privacy and security for such projects, and discuss issues related to data ownership that may also be part of such projects.

    The Risk of Data Sharing

    Play Episode Listen Later Mar 13, 2023 23:44


    1st Talk Compliance features guest Iliana L. Peters, Shareholder at Polsinelli PC, on the topic of The Risk of Data Sharing. Iliana joins our host Catherine Short to discuss how these days, health data is an incredibly valuable commodity. Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. In this episode, we will be discussing the scope and breadth of data sharing projects in development in the health care sector, examine contractual, state, federal, and international legal obligations for data privacy and security for such projects, and discuss issues related to data ownership that may also be part of such projects.

    DMEPOS – In Compliance with CMS

    Play Episode Listen Later Feb 22, 2023 27:03


    1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., on the topic “DMEPOS – In Compliance with CMS.” Rachel joins our host Catherine Short to discuss special payment rules associated with durable medical equipment, prosthetics, orthotics and supplies. DMEPOS products must meet quality standards, suppliers need to be accepted by Medicare to participate, similar to providers, and are subject to fraud, waste, and abuse laws. This episode will provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and discuss the consequences of non-compliance, as well as submitting false and fraudulent claims. 

    DMEPOS – In Compliance with CMS

    Play Episode Listen Later Feb 22, 2023 27:03


    1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., on the topic “DMEPOS – In Compliance with CMS.” Rachel joins our host Catherine Short to discuss special payment rules associated with durable medical equipment, prosthetics, orthotics and supplies. DMEPOS products must meet quality standards, suppliers need to be accepted by Medicare to participate, similar to providers, and are subject to fraud, waste, and abuse laws. This episode will provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and discuss the consequences of non-compliance, as well as submitting false and fraudulent claims. 

    Evaluation and Management Updates 2023, Training, Q and A- Audio Version of the Training

    Play Episode Listen Later Feb 21, 2023 101:42


    An audio version from the live event: It's important to understand how the application of the 2023 E&M codes impacts reimbursement. Inaccurate coding and inefficient documentation practices can result in a decline in revenue and increase the likelihood of downstream inaccuracies of patient data. Join Panacea Healthcare Solutions' Director of Coding & Documentation Services, Becky Jacobsen, CCS-P, CPC, CPEDC, CBCS, MBS, CEMC, BSN, and Executive Vice President of Coding & Documentation, Kathy Pride, RHIT, CPC, CCS-P, for a complimentary 90-minute training where they will review the 2023 E&M documentation guidelines and requirements and provide examples on how to improve your internal documentation processes to ensure appropriate reimbursement and avoid compliance issues.

    Evaluation and Management Updates 2023, Training, Q and A- Audio Version of the Training

    Play Episode Listen Later Feb 21, 2023 101:42


    An audio version from the live event: It's important to understand how the application of the 2023 E&M codes impacts reimbursement. Inaccurate coding and inefficient documentation practices can result in a decline in revenue and increase the likelihood of downstream inaccuracies of patient data. Join Panacea Healthcare Solutions' Director of Coding & Documentation Services, Becky Jacobsen, CCS-P, CPC, CPEDC, CBCS, MBS, CEMC, BSN, and Executive Vice President of Coding & Documentation, Kathy Pride, RHIT, CPC, CCS-P, for a complimentary 90-minute training where they will review the 2023 E&M documentation guidelines and requirements and provide examples on how to improve your internal documentation processes to ensure appropriate reimbursement and avoid compliance issues.

    The Criminal Side of Cybersecurity and HIPAA – Audio Version of the Webinar

    Play Episode Listen Later Feb 16, 2023 75:20


    Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us during this important and informative webinar. Breaches and the lack of the requisite technical, administrative, and physical safeguards can have criminal consequences. While most people are familiar with civil cases, there is the potential for HIPAA violations and ransomware attacks to be prosecuted criminally. The purpose of this webinar is to highlight potential areas of criminal liability, give specific examples, and address mitigation techniques - both before and after a government discovery request or grand jury subpoena emerges.

    The Criminal Side of Cybersecurity and HIPAA – Audio Version of the Webinar

    Play Episode Listen Later Feb 16, 2023 75:20


    Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us during this important and informative webinar. Breaches and the lack of the requisite technical, administrative, and physical safeguards can have criminal consequences. While most people are familiar with civil cases, there is the potential for HIPAA violations and ransomware attacks to be prosecuted criminally. The purpose of this webinar is to highlight potential areas of criminal liability, give specific examples, and address mitigation techniques - both before and after a government discovery request or grand jury subpoena emerges.

    Employee Snooping & Insider Threats

    Play Episode Listen Later Jan 10, 2023 29:16


    1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of “Employee Snooping & Insider Threats.” Ray joins our host Catherine Short to discuss snooping and insider threats and why user monitoring and ePHI access strategies are vital to the security of sensitive patient information and data protection. With so much attention and money surrounding cybersecurity in the healthcare industry, malicious employees may decide to purposefully disclose patient information. Since employees and contractors may have knowledge of your network setup, vulnerabilities, and access codes, snooping employees with malicious intent hold the key to exposing your organization to a series of unwanted risks and threats. Listen as we identify signs of unauthorized access, provide guidelines to prevent snooping, and offer procedures to detect insider threats.

    Employee Snooping & Insider Threats

    Play Episode Listen Later Jan 10, 2023 29:16


    1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of “Employee Snooping & Insider Threats.” Ray joins our host Catherine Short to discuss snooping and insider threats and why user monitoring and ePHI access strategies are vital to the security of sensitive patient information and data protection. With so much attention and money surrounding cybersecurity in the healthcare industry, malicious employees may decide to purposefully disclose patient information. Since employees and contractors may have knowledge of your network setup, vulnerabilities, and access codes, snooping employees with malicious intent hold the key to exposing your organization to a series of unwanted risks and threats. Listen as we identify signs of unauthorized access, provide guidelines to prevent snooping, and offer procedures to detect insider threats.

    Health Data, A Value Proposition: Legal Risks with Innovative Data Sharing Projects – Audio Version of the Webinar

    Play Episode Listen Later Dec 15, 2022 66:32


    Iliana L. Peters, Shareholder at Polsinelli PC will be leading this engaging audio version of her webinar presentation. These days, data is more valuable than oil. And health data is the most valuable of all data! Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. Data sharing projects take many forms and address many important issues, including improvements in patient safety, fraud and abuse, population health, research, and costs to the health care system. That said, the contractual, state, federal, and international regulatory requirements applicable to such data sharing projects are significant. As such, health care entities may be particularly vulnerable to legal risk related to data sharing projects involving health data. Specifically, health care entities should consider contractual obligation, HIPAA, state privacy laws, and other requirements, as well as discuss risk assessment, data sharing agreements, key provisions, and business associate relationships. The presentation offers best practices for these important issues and projects.

    Health Data, A Value Proposition: Legal Risks with Innovative Data Sharing Projects – Audio Version of the Webinar

    Play Episode Listen Later Dec 15, 2022 66:32


    Iliana L. Peters, Shareholder at Polsinelli PC will be leading this engaging audio version of her webinar presentation. These days, data is more valuable than oil. And health data is the most valuable of all data! Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. Data sharing projects take many forms and address many important issues, including improvements in patient safety, fraud and abuse, population health, research, and costs to the health care system. That said, the contractual, state, federal, and international regulatory requirements applicable to such data sharing projects are significant. As such, health care entities may be particularly vulnerable to legal risk related to data sharing projects involving health data. Specifically, health care entities should consider contractual obligation, HIPAA, state privacy laws, and other requirements, as well as discuss risk assessment, data sharing agreements, key provisions, and business associate relationships. The presentation offers best practices for these important issues and projects.

    A Harassment-Free Workplace vs the Right to Engage in Concerted Activity

    Play Episode Listen Later Dec 15, 2022 29:05


    1st Talk Compliance features guest Lauren Moak Russell, Counsel at Young Conaway Stargatt & Taylor, LLP in Wilmington, Delaware, on the topic of “A Harassment-Free Workplace vs the Right to Engage in Concerted Activity.” Lauren joins our host Catherine Short to discuss how the National Labor Relations Board under the Biden Administration has expressed a renewed interest in expanding its influence into non-unionized work forces. This includes reviewing and--in the right circumstances challenging--employers' use of workplace civility, confidentiality, and anti-harassment policies. Listen as we discuss what you need to know to safely navigate the National Labor Relations Act while ensuring that your employees enjoy a safe and respectful work environment.

    A Business Associate Agreement? Tell Me More!

    Play Episode Listen Later Nov 14, 2022 27:57


    1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “A Business Associate Agreement? Tell Me More!” Rachel joins our host Catherine Short to discuss how Business Associate Agreements (BAA) are not new; however, some individuals are new to healthcare and others never understood what a BAA is exactly. A BAA is a contract that fundamentally gives assurances that the parties are complying with the Security Rule and Privacy Rule, setting parameters in the event of a reportable security incident or a breach, and states how the sensitive data will be returned and destroyed at the end of the relationship. This presentation not only seeks to dispel myths about why certain language is prevalent in nearly all BAAs, but also provides insight into other provisions, and items for consideration, in light of the 21st Century Cures Act.

    A Business Associate Agreement? Tell Me More!

    Play Episode Listen Later Nov 14, 2022 27:57


    1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “A Business Associate Agreement? Tell Me More!” Rachel joins our host Catherine Short to discuss how Business Associate Agreements (BAA) are not new; however, some individuals are new to healthcare and others never understood what a BAA is exactly. A BAA is a contract that fundamentally gives assurances that the parties are complying with the Security Rule and Privacy Rule, setting parameters in the event of a reportable security incident or a breach, and states how the sensitive data will be returned and destroyed at the end of the relationship. This presentation not only seeks to dispel myths about why certain language is prevalent in nearly all BAAs, but also provides insight into other provisions, and items for consideration, in light of the 21st Century Cures Act.

    Have a Breach? Reporting Requirements with the OCR

    Play Episode Listen Later Oct 17, 2022 27:07


    1st Talk Compliance features guest Trey Scott, Coordinating Attorney at Kennedy, Attorneys & Counselors at Law, on the topic of “Have a Breach? Reporting Requirements with the OCR.”Trey joins our host, Catherine Short to discuss the reporting requirements for a data breach of a healthcare provider, the definition of a breach, different timelines for reporting breaches, as well as how to complete a breach reporting form from the Office of Civil Rights.

    Have a Breach? Reporting Requirements with the OCR

    Play Episode Listen Later Oct 17, 2022 27:07


    1st Talk Compliance features guest Trey Scott, Coordinating Attorney at Kennedy, Attorneys & Counselors at Law, on the topic of “Have a Breach? Reporting Requirements with the OCR.”Trey joins our host, Catherine Short to discuss the reporting requirements for a data breach of a healthcare provider, the definition of a breach, different timelines for reporting breaches, as well as how to complete a breach reporting form from the Office of Civil Rights.

    Preserving and Protecting Assets In Healthcare: Audio Version of the Webinar

    Play Episode Listen Later Oct 14, 2022 83:32


    Expert attorneys Sean McKenna, Lauren Nelson, and Vincent Aiello of Spencer Fane LLP will present this dynamic webinar. They will discuss the interplay between enforcement and liability proceedings with asset protection, explore how government and private litigation matters can impact healthcare companies, clinicians, and executives, and provide tips and preventative strategies to preserve income and assets prior to such action to ensure business continuity and succession planning.

    Preserving and Protecting Assets In Healthcare: Audio Version of the Webinar

    Play Episode Listen Later Oct 14, 2022 83:32


    Expert attorneys Sean McKenna, Lauren Nelson, and Vincent Aiello of Spencer Fane LLP will present this dynamic webinar. They will discuss the interplay between enforcement and liability proceedings with asset protection, explore how government and private litigation matters can impact healthcare companies, clinicians, and executives, and provide tips and preventative strategies to preserve income and assets prior to such action to ensure business continuity and succession planning.

    Automatic Dispensing Cabinets, Patient Care, and Nurse RaDonda Vaught: Audio Version of the Webinar

    Play Episode Listen Later Sep 13, 2022 65:02


    Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely and fascinating subject for us. A former nurse was charged, criminally prosecuted, and in March 2022, convicted of gross neglect of an impaired adult and negligent homicide for a 2017 fatal drug error. The purpose is to inform participants of a myriad of items so that facilities can evaluate and implement appropriate safeguards, train nurses and other staff, and take corrective actions before an adverse patient outcome occurs. What happened here is preventable and nurses should not flee the profession, especially because of the compassion shown by the judge.

    Automatic Dispensing Cabinets, Patient Care, and Nurse RaDonda Vaught: Audio Version of the Webinar

    Play Episode Listen Later Sep 13, 2022 65:02


    Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely and fascinating subject for us. A former nurse was charged, criminally prosecuted, and in March 2022, convicted of gross neglect of an impaired adult and negligent homicide for a 2017 fatal drug error. The purpose is to inform participants of a myriad of items so that facilities can evaluate and implement appropriate safeguards, train nurses and other staff, and take corrective actions before an adverse patient outcome occurs. What happened here is preventable and nurses should not flee the profession, especially because of the compassion shown by the judge.

    How New Legislation Impacts Privacy

    Play Episode Listen Later Sep 12, 2022 28:47


    1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “How New Legislation Impacts Privacy.” The Dobbs Opinion repealed fifty years of precedent under Roe. The implications of the Opinion extend beyond women's reproductive rights and impact the privacy rights of all Americans. The purpose of this episode is to explain the key aspects of the Dobbs Opinion related to privacy from both the Majority and the Dissent's perspective, address the current legislative initiatives, HHS Guidance, and Executive Orders, as well as appreciate the role HIPAA plays in navigating Dobbs.

    How New Legislation Impacts Privacy

    Play Episode Listen Later Sep 12, 2022 28:47


    1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “How New Legislation Impacts Privacy.” The Dobbs Opinion repealed fifty years of precedent under Roe. The implications of the Opinion extend beyond women's reproductive rights and impact the privacy rights of all Americans. The purpose of this episode is to explain the key aspects of the Dobbs Opinion related to privacy from both the Majority and the Dissent's perspective, address the current legislative initiatives, HHS Guidance, and Executive Orders, as well as appreciate the role HIPAA plays in navigating Dobbs.

    The Dobbs Opinion, the Repealing of Roe, & the Impact on the Privacy & Security of Patient Information – Audio Version of the Webinar

    Play Episode Listen Later Aug 9, 2022 73:45


    Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely subject for us.The Dobbs Opinion repealed fifty years of precedent under Roe. The implications of the Opinion extend beyond women's reproductive rights and impact the privacy rights of all Americans. The purpose of this webinar is to explain the key aspects of the Dobbs Opinion related to privacy from both the Majority and the Dissent's perspective, address the current legislative initiatives, HHS Guidance, and Executive Orders, as well as appreciate the role HIPAA plays in navigating Dobbs.

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