Podcast appearances and mentions of John K Hall

National Doctors' Day is Sunday, March 30. Even though the national one-day observance is only a few days away, the ICD10monitor producers of Talk Ten Tuesdays want to ensure that everyone is aware of the significant contributions made daily by America's doctors. Hence, our recognition of the occasion will continue during the next live edition of the popular weekly Internet broadcast.As part of the celebration, physician and attorney Dr. John K. Hall has been invited to be the special guest on Talk Ten Tuesdays. Dr. Hall, a popular panelist on Monitor Mondays, has distinguished himself as an astute reporter of healthcare news: he introduced the audience to the concept of Chevron Deference at the time when little information was available on an unprecedented development.Dr. Hall will report on two virus outbreaks in particular that have captured the attention of Americans.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

“He's making a list, checking it twice…”With a nod to the legendary Tin Pan Alley composer Haven Gillespie, who penned the lyrics to the iconic holiday song, senior healthcare consultant Ronald Hirsch, MD has been making his own list of healthcare professionals all year, paying close attention to their deeds in the field of healthcare.Calling them “Hirsch's Heroes,” an annual tradition that began in 2015, Hirsch will reveal those to whom he has bestowed the esteemed honor during the next live edition of Monitor Mondays.Other broadcast segments will include these instantly recognizable features:• The RAC Report: Healthcare attorney Knicole Emanuel will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Field Report: Phyisican and attorney Dr. John K. Hall is expected to file a field report on the recent Anthem Blue Cross Blue Shield proposal relative to its anethesia policy which the giant payer has since abandoned.• Legislative Update: Matthew Albright, chief leglistative affairs analyst for Zelis, will report on the latest legislative actions impacting the healthcare regulatory setting.

Have you ever had your insurance company deny payment for your claim?Have you ever had your insurance company stall or deny a pre-authorization?How long did it take to get the authorization for the medication you've been using to keep yourself alive for the past few years? Was it maddening?During the next edition of Monitor Mondays, physician and attorney Dr. John K. Hall will examine the frustration that modern health insurance has become – especially in the context of the recent fatal shooting of a prominent health insurance chief executive officer (CEO).Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Adam Brenman, senior healthcare legislative affairs analyst for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

A pediatrician under investigation related to accusations that she had engaged in sexual relations with a male patient, having lied about it when applying for another healthcare position, was recently sentenced for making false statements.In another case, a federal contractor agreed to resolve False Claims Act allegations in connection with a government contract related to its storage of unsecured personally identifiable information of Medicare beneficiaries.Recognizing that it's not only a bad idea, but also a crime to lie to a government agency, Monitor Monday's own attorney and physician Dr. John K. Hall will report on how your organization's cybersecurity could put you at risk of false claims liability during the next live edition of the long-running Internet radio broadcast. Specifically, Dr. Hall will review these two recently resolved cases and offer tips to avoid liability.Other segments during the weekly broadcast will include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

What's wrong with this picture?With more than 10 years of the Centers for Medicare & Medicaid Services (CMS) Two-midnight Rule now behind us, one would presume that most healthcare professionals should know what determines an inpatient status. But some don't.That is why RACmonitor has invited renowned physician and attorney Dr. John K. Hall to report on the requirements and risks associated with inpatient order documentation during the next edition of Monitor Mondays.Other segments during the weekly Internet broadcast will include these instantly recognizable features:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.Legislative Update: Cate Brantley, a senior government affairs liaison for Zelis, will report on current healthcare legislation.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Could the end be near for the administrative law judges of the Centers for Medicare & Medicaid Service (CMS). What about the Office of Medicare Hearings and Appeals (OMHA)? Could these entities be gone from the audit landscape?Case in point: the Supreme Court (SCOTUS) continues eviscerating executive powers. This time SCOTUS has limited the authority of administrative tribunals and the administrative law judges to adjudicate some cases—this according to a recent SCOTUS decision.While the actual case relates to administrative hearings at the Securities and Exchange Commission (SEC), the limitations likely transcend that agency.During the next live edition of Monitor Monday, physician and attorney, Dr John K Hall, will discuss the potential impacts of the decision and what impact it might have on Office of Medicare Hearings and Appeals (OMHA) and the Centers for Medicare & Medicaid Services (CMS) administrative law judges.Other broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Cate Brantley, a senior government affairs liaison for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

For nearly four decades, a judicial principle known as “Chevron deference” has guided the federal courts as they reviewed litigation associated with federal agencies. Chevron deference allowed legislators to leave statutes somewhat vague, assuming that an agency full of government experts would sort out the details and promulgate effective regulation.But, according to a recent U.S. Supreme Court (SCOTUS) decision, the principle is fundamentally flawed – in fact, fatally flawed. The decision throws it out in its entirety. This has the potential to upend years of U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) regulation.Distinguished physician and attorney Dr. John K. Hall will report on the resultant doom and gloom of potential outcomes, and how it may affect providers and payers, during the next live edition of Monitor Mondays.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Most healthcare investigations by the U.S. Department of Justice (DOJ) result in settlements. Many times, the complete details of the settlements in underlying government cases are not fully disclosed. But sometimes, a provider ends up at trial. And when that happens, it often offers insights into what it takes to get hit with hefty fines – and possible prison time, if you lose the case.During the next live edition of Monitor Mondays, physician and attorney Dr. John K. Hall will review two recent convictions against individual physicians, and offer suggestion for avoiding big payouts and incarceration.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Adam Brenman, a senior government affairs liaison for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Do you have peer-to-peer (P2P) discussions?Are they useful? Are they valuable? And how do you know?Our own physician and attorney, Dr. John K. Hall, will offer his unique take on the value of P2P interactions and how you should measure it during his appearance as Guest Panelist on the next upcoming edition of Monitor Mondays.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Matthew Albright, a senior government affairs liaisons for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

What happens if the Supreme Court of the United States (SCOTUS) dismantles decades of government agency discretion? Recent cases at SCOTUS indicate that this could happen. But what would be the consequences?During the next live edition of the long-running Internet radio broadcast Monitor Mondays, RACmonitor's own physician and attorney Dr. John K Hall will consider the ramifications of the demise of the so-called “Chevron Deference” currently enjoyed by federal agencies.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, federal legislative analyst for Zelis, will report on current healthcare legislation.

What happens if the Supreme Court of the United States (SCOTUS) dismantles decades of government agency discretion? Recent cases at SCOTUS indicate that this could happen. But what would be the consequences?During the next live edition of the long-running Internet radio broadcast Monitor Mondays, RACmonitor's own physician and attorney Dr. John K Hall will consider the ramifications of the demise of the so-called “Chevron Deference” currently enjoyed by federal agencies.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, federal legislative analyst for Zelis, will report on current healthcare legislation.

No more eggnog. Toss the champagne bottles. The good times are over, and now it's back to business. But not business as usual. As the rest of the nation's healthcare professionals clocked in for overtime, claims auditors were scrutinizing medical records, looking for the slightest inconsistency upon which to pounce. Now, nearly four weeks since its last news broadcast, Monitor Mondays will return this coming Monday with a cadre of the smartest minds in healthcare auditing. You'll hear auditing news you won't find anywhere else – except here and in RACmonitor.Broadcast segments will include these instantly recognizable features:·Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. ·The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.  · Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment. · Home Care and Hospice: William Dombi, president and CEO for the National Association for Home Care and Hospice, will report on the latest news concerning Medicare home health and hospice but also Medicaid's Home & community-based services (HCBS). ·Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on current healthcare legislation. ·Docs and Regs: Monitor Mondays' own physician and attorney, Dr. John K. Hall, will report on the impact of artificial intelligence on healthcare. · Tech Report: RACmonitor investigative reporter Edward M. Roche will report on the latest technology trends impacting America's healthcare delivery system. · Lead Story: Frank Cohen, founder of the Frank Cohen Group will report on his recent study about how major changes to the 2021 evaluation and management (E&M) services is impacting 2024 E&M coding and compliance.

The Two-Midnight Rule was first announced 10 years ago, October 2013, by the Centers for Medicare & Medicaid Services (CMS). Even today, though, the Rule remains an ongoing source of confusion for physicians as well as revenue cycle and finance experts.However, it also will take on new importance, as CMS promises that Medicare Advantage (MA) plans will begin to follow the Rule in 2024.During the next live edition of the popular and long-running Internet broadcast Monitor Mondays, physician and attorney Dr. John K. Hall will summarize the current state of the Two-Midnight Rule and offer insights of its use into the next decade.Other broadcast segments will also include these instantly recognizable features:• Monday Rounds: Dr. Ronald Hirsch, vice president of R1 RCM, will make his Monday Rounds.• The Whistleblower Report: Famed whistleblower attorney Mary Inman, partner in the law offices of Constantine Cannon, will report on the latest news concerning whistleblowers.• The RAC Report: Healthcare attorney Knicole Emanuel will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on the latest legislative actions impacting the healthcare regulatory setting.

So far in October, the U.S. Department of Justice (DOJ) has been very busy, securing settlements, pleas, and convictions ranging in value from $25 to $350 million.And just this month, DOJ announcements have featured settlements related to Anti-Kickback and Stark violations, as well as convictions in genetic testing schemes and guilty pleas for fraud involving unnecessary testing.During the next live edition of Monitor Mondays, RACmonitor's own physician and attorney, Dr. John K. Hall, will break down some of these recent reports to give you additional insights and help you understand your own risk.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Dr. Ronald Hirsch, vice president of R1 RCM, will make his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Folana Houston, assistant general counsel for Zelis, will report on the latest legislative actions impacting the healthcare regulatory setting.

Although the 21st Century Cures Act was enacted in 2016, many hospitals today continue to struggle with effective implementation of its provisions and the goal of preserving patient access to medical records.Seven years later, however, meaningful guidance regarding its enforcement is here. One of the provisions requires developers not to engage in information blocking.Now that the guardrails are in place and the risks have been identified, Monitor Monday's own physician and attorney Dr. John K. Hall will review the related enforcement actions and the penalties during the next live edition of the long-running Internet broadcast.Broadcast segments will also include these instantly recognizable features:Monday Rounds: Ronald Hirsch, vice president of R1 RCM, will make his Monday rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullen, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.Legislative Update: Cate Brantley, a legislative analyst for Zelis, will report on current healthcare legislation.

This week, a disgraced Elizabeth Holmes was seen in media clips walking in the company of two unidentified men. Evidently, Holmes, who was convicted of fraud for her blood-testing start up, Theranos, turned herself in at a minimum-security prison in Texas to begin an 11-year prison term.All this media coverage raises the question: how easy is it to run afoul of the government regarding a wide range of statutes and regulations?Moreover, how far do you have to go to actually get to prison? During the next live edition of Monitor Mondays, physician and attorney Dr. John K. Hall will examine some recent convictions and sentences to help you assess your risk – keeping in mind that there's no parole from federal prison.Broadcast segments will also include these instantly recognizable features:Monday Rounds: Bonney Olney, director of Level of Care Service for R1 RCM, will make her Monday rounds, substituting for Dr. Ronald Hirsch.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullen, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Legislative Update: Cate Brantley, JD, a legislative analyst for Zelis, will report on current healthcare legislation.

Your medical staff office just notified you that a physician has been performing procedures without privileges for the past five years.No, it doesn't happen all the time. But what should you do?Physician and attorney Dr. John K. Hall will walk you through the considerations and help you understand how much revenue might be in jeopardy during the next live edition of Monitor Mondays.Broadcast segments will also include these instantly recognizable features:Monday Rounds: Ronald Hirsch, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullen, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Legislative Update: Folana Houston, assistant general counsel for Zelis, will report on current healthcare legislation.The Wrapper: John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning's top stories.& so much moreA bi-monthly podcast where we share the stories of our Caregivers, patients and...Listen on: Apple Podcasts Spotify

Imagine for a moment that the federal government, through one of its contractors, sends you money for services you don't believe are covered benefits for a particular patient at your facility.But wait. Don't react just yet.The best course of action might not be what you think, and it's definitely not simple or straightforward, as you'll learn during the next live edition of the long-running Monitor Mondays Internet radio broadcast. That's when physician and attorney Dr. John K. Hall will explore the mysteries of Advance Beneficiary Notices (ABNs) and reverse false claims.Broadcast segments will also include these instantly recognizable features:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullen, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Legislative Update: Adam Brenman, federal legislative analyst for Zelis, will report on current healthcare legislation.The Wrapper: John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning's top stories.

The concern is real. And it's growing.Providers could incur False Claims Act (FCA) liability when care that is delivered crosses over from “worth less” to “worthless.” You need to know where to draw the line. And that's why we asked physician and attorney John K. Hall to explain, during the next live edition of Monitor Mondays.Broadcast segments will also include these instantly recognizable features:Special Report: Prominent healthcare attorney Andrew Wachler, managing partner at Wachler and Associates, will return to the broadcast to report on meeting the 90-day statutory timeframe for administrative law judge (ALJ) hearings.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Legislative Update: Cate Brantley, a legislative analyst for Zelis, will report on current healthcare legislation.The Wrapper: John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning's top stories.

In May 2022, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a report claiming that 25 percent of Medicare patients experienced adverse events during their October 2008 hospital stay.“That's a staggering number,” said John K. Hall, MD, in an email to RACmonitor. “So, what does it mean, and what should providers expect from other auditors and government agencies?”During the next live edition of Monitor Mondays, physician and attorney Dr. Hall will review the report and offer suggestions to prepare if the OIG comes knocking at your door.Broadcast segments will also include these instantly recognizable features:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.LiveStream Chat: Dr.John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning's top stories.

No more eggnog. Toss the champagne bottles. The good times are over, and now it's back to business. But not business as usual.As the rest of the nation's healthcare professionals clocked in for overtime, claims auditors were scrutinizing medical records, looking for the slightest inconsistency upon which to pounce. Now, nearly four weeks since its last news broadcast, Monitor Mondays will return this coming Monday with a cadre of the smartest minds in healthcare auditing. You'll hear auditing news you won't find anywhere else – except here and in RACmonitor.Broadcast segments will include these instantly recognizable features:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds, during which he will report an exclusive auditing story in which he details news about a move by the Centers for Medicare & Medicaid Services (CMS) to clamp down on Medicare Advantage (MA).The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Legislative Update: Cate Brantley, a federal legislative analyst for Zelis, will report on current healthcare legislation.Docs and Regs: Monitor Mondays' own physician and attorney, Dr. John K. Hall, will report on how revisions to water down the Medicare Program Integrity Manual tend to increase liability for providers.Tip Sheet: RACmonitor investigative reporter Edward M. Roche will have another jaw-dropping story about audits, auditing, and a dismal outlook for 2023.Live Stream Chatting: Dr.John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning's top stories.

We've all watched in awe as the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) began investigating the Medicare Advantage plans. Many were thinking, “it's about time the payers get some of the heat providers feel.” But there's something even better, according to most. That's when the OIG investigates the government.During the next live edition of Monitor Mondays, physician-attorney Dr. John K. Hall reviews an OIG audit of Medicare contractors and the Centers for Medicare & Medicaid Services (CMS). He'll also explain what this means for providers.Other segments will include these instantly recognizable broadcast features:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.

Most healthcare providers are swimming in shark-infested waters these days, ever-watchful for dorsal fins that signal imminent danger.  At first there were the Recovery Auditors (RAs), created by the Centers for Medicare & Medicaid Services (CMS), to correct Medicare billing submitted by providers for services rendered to Medicare beneficiaries. And now, nearly two decades later, the RAs have been joined by several other auditors, and healthcare has quickly become a dangerous and expensive environment, especially given a new breed of sharks: the Medicare Advantage Organizations (MAOs), whose primary mission is to save money by denying claims in the name of compliance.Join us next Monday for another live edition of the long-running Monitor Mondays Internet broadcast for a news round-up, and to learn of more lurking dangers and how to protect your facility's revenue while remaining compliant, even amid all the turmoil.Other segments will include these instantly recognizable broadcast features:OIG Report: Monitor Monday's own physician and attorney, Dr. John K. Hall, will report on the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) audit of critical care billing at Leahy Clinic in Boston. If you have an ICU, you will need to hear his report.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.SDoH Report: Marie Stinebuck, COO of Phoenix Medical Management, Inc, will report on the news that's happening at the intersection of healthcare regulations and the SDoH. Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Adam Brenman, Federal Legislative Analyst for Zelis, will report on current healthcare legislation.

DRG validation denials by Medicare Advantage (MA) plans have become a widespread and increasing concern for many hospitals.But these denials may be the result of a misapplication of standard diagnostic criteria by a reviewer. Now, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is turning the DRG validation denials back on MAs. The OIG recently published several diagnosis-validation audits of MAs and recommended recoupment for exactly the same diagnoses the MAs have denied for providers.But what can we learn from these audits to help manage diagnosis denials by payers? Does this portend new MA tactics? Sitting in for Dr. Ronald Hirsch during the next edition of Monitor Mondays will be our own physician and attorney, Dr John K. Hall, who will offer his take on the future of diagnosis denials and how to prepare.Other segments will include these instantly recognizable broadcast segments:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors;Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment;SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH; andLegislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.

Although the “Inflation Reduction Act (H.R. 5376)” is still alive and headed to President Biden's desk for his signature, there are provisions, deep inside the proposed legislation that will lower health care and prescriptions drug costs and could impact beneficiaries of some government-sponsored health insurance plans.During the next live edition of Monitor Mondays, physician and attorney Dr John K. Hall will autopsy the bill, dissecting the legislation to uncover some of the relevant provisions while adding fine points and adds necessary context to this important legislation.Other segments will include these instantly recognizable broadcast segments:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.

The recent decision by the Supreme Court to invoke the major questions doctrine to nullify an agency regulation in the case of West Virginia versus the Environmental Protection Agency seems to indicate the court's trend toward increasingly strict interpretation of statutes. The possibility that new, or even well-established, regulations may be overturned means that healthcare regulation could change drastically on extremely short time scales with no direct input from stakeholders. During the next live edition of Monitor Mondays, physician and attorney Dr. John K. Hall explains the major questions doctrine and its potential impact on healthcare.Other segments will include these instantly recognizable broadcast segments:The RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will report the latest news about auditors.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Risky Business: Healthcare attorney David Glaser, a shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.

Stranger than fiction are the reports coming from providers complaining of inconsistent and often contradictory reasons given for claim denials, leading to recoupment and the possibility of Medicare revoking privileges of participation in federal health programs – and this at a time of shrinking margins, rising inflation, budget cuts, and staff shortages. Little wonder that America's hospitals, health systems, and physician practices are feeling the pain.However, during the next special news edition of Monitor Mondays, you will not only hear field reports from our distinguished and highly respected panelists, but also gain the benefit of practical guidance in traversing the treacherous audit terrain.And, as a special added feature, Monitor Mondays will conduct an exclusive roundtable on the contentious and controversial 340B drug discount program. Substituting for the program's executive producer and program host, Chuck Buck, will be Dr. John K. Hall.Other segments will include these instantly recognizable broadcast segments:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Cate Brantley, legislative affairs analyst for Zelis, will report on current healthcare legislation. Brantley will be substituting for Matthew Albright.

The 2022 audit landscape is rife with pitfalls and quicksand, trapping unsuspecting hospitals, health systems, and physician practices into a financial quasi-death spiral.And now, there's another major disruptor: Condition Code 44, which continues to confound providers and revenue cycle professionals. Even though the Recovery Audit Contractors (RACs) have been held at bay, there are new audits targeting the proverbial low-hanging fruit, ripe for the picking. Complicating an already dismal radar screen is the return of the Inpatient-only List, bringing enormous confusion and creating the perfect setup for more audits.Following news updates from a cadre of venerable Monitor Mondays panelists, a grouping of experts will regather around the virtual roundtable during the next edition of the live Internet broadcast, where, led by Dr. John K. Hall, attorney and physician, they will offer advice, answer your questions in real time, and forecast upcoming audits.Preceding the roundtable, “Tales from the Audit Trail,” will be the following instantly recognizable broadcast segments:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.Roundtable Moderator: John K. Hall, MD, will facilitate the roundtable discussion focused on Condition Code 44.

Like the insidious omicron variant of the COVID-19 virus, America's healthcare auditors are, in many cases, auditing claims with complete abandon, forsaking rules created specifically to curb payor abuse. And driven by profit motive, many commercial payors, in fulfilling their corporate mandate to manage risk and save money, find the low-hanging fruit to be ripe for harvesting.While the Centers for Medicare & Medicaid Services (CMS) continues to punish providers for claims submitted with errors of omission, the same disciplinary action is infrequently demonstrated publicly against payors behaving badly. It's little wonder, in today's highly regulated healthcare environment, that the audit landscape is fraught with peril for providers. Most notably, Medicare Advantage (MA) plans can tend to skirt the rules and audit records recklessly.For the latest national updates on auditing gone awry, listen to the next live edition of Monitor Mondays.Learn from an array of trusted subject matter experts who will report on the auditing landscape, while explaining how to protect your facility from recoupment of revenue:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors, including the Recovery Auditors (RAs).The Whistleblower Report: RACmonitor's resident physician and attorney, Dr. John K. Hall, will report on the unusual verdict in the case of Sheldon versus Allegan Sales, LLC.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment. Legislative Update: Cate Brantley, Legislative Analyst at Zelis Healthcare, will report on current healthcare legislation.SDoH Report: Lenel James, MBA, will report on the news that's happening at the intersection of healthcare regulations and the SDoH.

It has been more than 10 years since Richard Bagnall filed suit against Kathleen Sebelius, in her role as Secretary of the U.S. Department of Health and Human Services (HHS). Since then, the case has been recaptioned several times, and bounced back and forth between the U.S. District Court for Connecticut and the U.S. Court of Appeals for the Second Circuit. But the class-action suit, now known as Barrows v. Becerra, finally now has a decision from the latter.RACmonitor's physician and attorney, John K. Hall, will return to the Monitor Mondays broadcast to report on whether the decision is reason for you to get excited – or just shrug.Other segments to be featured during the live broadcast include the following:Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on current healthcare legislation.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of healthcare regulations and the SDoH.

Operating with virtual impunity, while relying on artificial intelligence, payor auditors have locked on to providers to deny claims that trigger audits.Acts of omission by providers are often deemed acts of commission in the eyes of auditors – and the audits often lead to recoupment. Even the slightest apparently innocuous action can trigger a cascade of negative reactions, including denials.  Even knowing of misconduct is a major problem. During the next live edition of Monitor Mondays, healthcare attorney and physician John K. Hall will continue his two-part series on the consequences of seemingly inconsequential errors, and “fraud” that could very well just be the byproduct of other actions.Monitor Mondays will also have the latest national audit news updates from well-respected broadcast consultants, including::Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return with another installment of his popular segment.RAC Report: Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington, D.C.SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will have the latest news on a trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listeners Survey.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.

UnitedHealthcare is the latest insurer to join the growing lineup of payors that want to second-guess patients and deny payment for emergency department (ED) services after they've been rendered.As reported here on Monitor Mondays last week, UnitedHealthcare plans to extend no coverage or limited coverage to ED claims, retroactively – including any claims the giant insurer deems non-emergent. Our own Dr. John K. Hall will report on this recent development during the next edition of the Monitor Mondays broadcast, offering tips on how to prepare for the consequences of these denials.Other segments to be featured during the live broadcast include the following:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return to make his Monday Rounds with another installment of his popular segment.RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington, D.C.Court Report: Famed whistleblower attorney Mary Inman, partner at the London office of Constantine Cannon, will return to the broadcast to report on the latest wrinkle in the whistleblower lawsuit launched by Integra Med Analytics. The Department of Justice (DOJ) has intervened in one Integra case against 11 nursing homes.

“Incoming!” are the typical dreaded shouts heard from soliders hunkered down in bunkers when shelling begins.Today, across America, you can hear the same cries when it comes to claims auditing. Audits are incoming. Third-party auditors, governmental auditors, even auditors from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) looking at COVID-related claims are incoming – and the onslaught is occurring in rural hospitals as well as big city health systems and teaching facilities alike.Does this portend a future of escalating audits? During the next live edition of Monitor Mondays, an all-star lineup of audit and regulatory experts will come together in a 60-minute edition of the venerable weekly broadcast.The live broadcast includes the following:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will make his Monday Rounds with another installment of his popular segment.RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.Risky Business: Healthcare attorney David Glaser, a shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.Social Determinants of Health: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will report on the latest news that’s occurring at the intersection of healthcare and socioeconomics. Ellen will also conduct the Monitor Mondays Listeners Survey.The Court Report: Famed whistleblower Mary Inman, a partner in the London office of Constantine Cannon, will report on three notable whistleblower suits, all involving well-known healthcare brands.The Analysis: E&M 2021 Guidelines: Senior healthcare analyst Frank Cohen, director of business intelligence for DoctorsManagement, will report on his latest analysis of evaluation and management (E&M) 2021 guidelines for office visits; noteworthy will be his analysis of medical necessity audits.Utilization Management versus Utilization Review: Dr. John Zelem, founder of Streamline Consulting Services, will return to the broadcast to explain why utilization management and utilization review are not to be used interchangeably, yet they are, with increased frequency.Jab City, USA: Dr. John Foggle, Adjunct Associate Professor of Emergency Medicine at the Warren Alpert Medical School of Brown University, and an authority on the coronavirus will return to the broadcast to report on vaccine rates in the U.S. – as most experts warn that herd immunity is not likely to be achieved in the near future.Law and Order: Monitor Mondays’ own physician and attorney, Dr. John K. Hall, will report on the 11th Circuit Court of Appeals decision in the American College of Emergency Medicine versus Blue Cross and Blue Shield of Georgia. Understanding and applying the court's decision will help you and your team when faced with denials for services provided in your emergency department.

They’re using text messages. They’re offering vaccination cards, and even COVID-19 testing. They’re scammers.The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is currently warning that providers that charge impermissible fees must refund them, and ensure that individuals are not charged any sum at all, for the COVID-19 vaccine – along with warning of fraudulent telemarketing calls and even door-to-door visits. Of particular concern are scammers pretending to be COVID-19 contact tracers.“Legitimate contact tracers will never ask for your Medicare number or financial information, or attempt to set up a COVID-19 test for you and collect payment information for the test,” the OIG notes on its website.Just how prevalent are these scams? Reporting our lead story during the next live edition of Monitor Mondays will be RACmonitor investigative reporter Ed Roche, who was among the very first to report on contact tracers during the early stages of the pandemic, here on Monitor Mondays and RACmonitor.Other segments to be featured during the live broadcast include the following:RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.Social Determinants of Health: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will report on the latest news that’s occurring at the intersection of healthcare and socioeconomics. Ellen will also conduct the Monitor Mondays Listeners Survey.Monday Rounds: Attorney and physician John K. Hall, MD, founder of the Aegis Firm, will be pinch-hitting for Ronald Hirsch, MD, who regularly makes his rounds on Monitor Mondays.

With little in the way of reporting on the backlog of appeals at the Administrative Law Judge (ALJ) level, you could conclude that such hearings are on hiatus.But that’s not the case, according to senior healthcare consultant Frank Cohen, who will be reporting the lead story during the next live edition of Monitor Mondays. Cohen, director of business intelligence at DoctorsManagement, is expected to report that while he had testified at four ALJ hearings in all of 2019-2020, he has already testified at four so far this year, with four more between now and June – all pertaining to cases from 2014-2015. Ask Cohen why the Recovery Audit Contractors (RACs) are to blame for the backlog – his answer will be one you may not expect.Other segments to be featured during the live broadcast include the following:RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.Social Determinants of Health: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will report on the latest news that’s occurring at the intersection of healthcare and socioeconomics. Ellen will also conduct the Monitor Mondays Listeners Survey.Monday Rounds: Attorney and physician John K. Hall, MD, founder of the Aegis Firm, will be pinch-hitting for Ronald Hirsch, MD, who regularly makes his rounds on Monitor Mondays.

The World Health Organization (WHO) gave us the International Classification of Diseases (ICD), including several updates over the years, more recently versions 9 and 10.And now on the horizon is version 11.Thus, it is only fitting that Talk Ten Tuesdays would focus on the global accomplishments of the WHO this week, with the lead story for this upcoming edition focusing on the looming implementation of the new update for the standard code set. Leading off the reporting will be the broadcast’s special guest, Lorraine Fernandes, president of the International Federation of Health Information Management Associations (IFHIMA). Lorraine will report on the efforts by the organization to further advance the implementation of ICD-11.The live broadcast will also feature these other segments:CDI Report: Senior healthcare consultant and physician Alba Kuqi will make her Talk Ten Tuesdays debut with her report on clinical documentation integrity (CDI).Coding Report: Gloryanne Bryant, senior healthcare consultant, will report on First Quarter Coding Clinic.Tuesday Focus: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists (NAMAS), will return to the broadcast with an update on evaluation and management (E&M) codes.RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.Attorney and physician John K. Hall will be substituting as guest host for the vacationing Dr. Erica Remer.

Healthcare data breaches and the possibility of sanctions from the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) are a rightfully terrifying possibility for healthcare administrators.But one hospital, MD Anderson Cancer Center, recently fought back and won. Reporting on the outcome of the decision handed down by the 5th Circuit Court of Appeals during the next live broadcast of Monitor Mondays will be Dr. John K. Hall, a physician and attorney. Hall, founder of the Aegis Group, will provide an analysis of the case, while offering valuable lessons that can be learned from it.Other segments to be featured during the live broadcast include the following:Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the status of healthcare legislation associated with the current COVID-19 pandemic.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment. RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will report the Monitor Mondays lead story.

http://www.whisky.de/p.php?id=FORTY0CP0 Nosing 03:36 Wir verkosten den Forty Creek Copper Pot Reserve. Die kanadische Fourty Creek Brennerei wurde in einer besonderen Zeit gegründet: In den 90er Jahren gab es aufgrund der Unbeliebtheit von Whisky in Kanada lediglich noch wenige Brennereien im 'Großen Weißen Norden'. Genau in dieser Zeit gründete der erfahrene Weinmacher John K. Hall 1992 seine Forty Creek Brennerei in Grimsby, Ontario. Der Ort in der Niagara-Region ist bekannt für seine guten Weine und nun auch für Whiskys. Der Cooper Pot Reserve wird für ein besonders intensives Aroma mit höherem Alkoholgehalt abgefüllt. Jetzt auch als Podcast: https://www.whisky.de/shop/newsletter/#podcast Geschmacksbeschreibungen und Informationen finden Sie in unserem Shop auf Whisky.de Abonnieren http://www.youtube.com/user/thewhiskystore?sub_confirmation=1 Instagram: https://www.instagram.com/whisky.de/

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently closed in on more than 345 defendants charged with participating in scams involving more than $6 billion in alleged losses to federal healthcare programs.The takedown occurred in September, according to the OIG. Of that amount, approximately $4.5 billion was associated with telemedicine schemes. The action by the feds puts a spotlight on the growing use of telehealth as a consequence of the ongoing coronavirus pandemic.Reporting our lead story during this edition of Monitor Mondays is John K. Hall, an attorney and physician.Other segments to be featured during the live broadcast include the following:RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, files the Monitor Mondays RAC Report.SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), reports on the news that’s happening at the intersection of COVID-19 and the SDoH. Ellen also conducts the Monitor Mondays Listeners Survey.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the status of healthcare legislation associated with the current COVID-19 pandemic. Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, joins the broadcast with his trademark segment, reporting on legal implications that have the potential to put providers at risk.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.

The omnipresent coronavirus pandemic continues to upend lives, from mundane occasions like grocery shopping to long-planned space exploration missions. The pandemic is manifesting itself from the halls of Congress to the cubicles at Centers for Medicare & Medicaid Services (CMS) headquarters, to classrooms, theatres, homes, and places of worship, among other venues.On the next live edition of Monitor Mondays, we will explore the impact of the coronavirus on audits and auditing, proposed rules, guidance, and waivers.Joining the broadcast to report on anticipated pandemic-related audits will be Dr. John K. Hall, founder of The Aegis Firm, a healthcare consulting firm. Dr. Hall, also an attorney, will discuss these types of scenarios, and how to prepare for the inevitable denials coming your way.Also during the 60-minute broadcast, you’ll hear from Dr. John Foggle, Adjunct Associate Professor of Emergency Medicine at the Alpert Medical School of Brown University, who will provide a much-needed perspective on the impact of the prolonged epidemic. And making her debut appearance on Monitor Mondays will be Julia K. Brodt, PhD, an educator and former epidemiologst, who will provide a layperson’s background on antibodies, which are fundamental in the quest for a vaccine.Other segments to be featured during the podcast include:RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, files the Monitor Mondays RAC Report.SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), reports on the news that’s happening at the intersection of COVID-19 and SDoH. Audit Report: Sean Weiss, compliance officer for DoctorsManagement, returns to the broadcast with the Monitor Mondays Audit Report.Legislative Update: Former CMS official Matthew Albright, now chief legislative affairs officer for Zelis, reports on the status of healthcare legislation associated with the current COVID-19 pandemic.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, joins the broadcast with his trademark segment, reporting on legal implications during the pandemic.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.IRF Report: Angela Phillips, PT, president and chief executive officer for Image and Associates, reports on the the CMS final rule for the inpatient rehabilitation facility (IFR) prospective payment system for the 2021 fiscal year.

Could Alexander VS. Azar really be over? This week's Monitor Mondays episode we've called upon or resident healthcare attorneys Knicole Emanuel Esq., David Glaser Esq. and our guest host John K. Hall MD, JD to dissect and assess the complicated case.The case has been disorganized since the beginning, possibly leaving more questions than answers. This Monitor Mondays round table will analyze procedural aspects of the case and what it could potentially mean for providers, analyze where the decision has risk for providers, and provide guidance of how providers should respond in the future.Other segments to be featured during the live weekly Internet radio broadcast include the following:SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will report on the latest research from the Urban Institute and Robert Wood Johnson Foundation about Unemployment, and Loss of Employer-sponsored insurance. Ellen will also conduct the Monitor Mondays Listener Survey.Legislative Update: Former CMS official Matthew Albright, now chief legislative affairs officer for Zelis, will have the latest legislative news coming from Washington.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.Court Report: Mary Inman, Esq. has the latest report on Pfizer's charitable contributions and what future court rulings affect on the industry, and drug prices.

Welcome to the new normal. You and your team continue to be challenged by consequences of the coronavirus pandemic, dealing with PPE shortages, along with confusing and oftentimes contradictory guidance from the Centers for Medicare & Medicaid Services (CMS).And now, we look onward – toward the audit horizon, and looming denials for COVID-related care. You need to be aware of ongoing payor expectations and potential risk areas for denials. Returning to Monitor Mondays to report our lead story during this edition of the weekly Internet radio broadcast will be Dr. John K. Hall, founder of The Aegis Firm, a healthcare consulting firm. Dr. Hall, also an attorney, discusses these types of scenarios, and how to prepare for the inevitable denials coming your way.Other segments featured during the podcast:RAC Report: Healthcare attorney Knicole Emanuel, files the Monitor Mondays RAC Report.SDoH Report: Ellen Fink-Samnick, reports the news that’s happening at the intersection of COVID-19 and SDoH. Ellen will also conduct the Monitor Mondays Listener Survey.Legislative Update: Former CMS official Matthew Albright, reports on the status of key healthcare legislation.Risky Business: Healthcare attorney David Glaser, joins the broadcast with his trademark segment.Monday Rounds: Ronald Hirsch, MD, makes his Monday Rounds with another installment of his popular segment.

Do you know the statutory and regulatory requirements to avoid jeopardizing payment for you and your skilled nursing facility (SNF)?You need to know because the Recovery Audit Contractors (RACs) and other contractors are reviewing SNF referrals. Reporting our lead story is physician and attorney John K. Hall, founder of the Aegis Firm. Hall reviews such statutory and regulatory requirements while also making recommendations for audit readiness.Other segments to appear during the broadcast:RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report the latest audits by RACs and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group.Hurricane Watch: Dr. Daniel Zirkman, the chief physician advisor at CarolinaEast Medical Center in New Bern, N.C., reports on how his facility prepared for Hurricane Dorian, which forced the mandatory evacuation of nearly 400,000 residents in that state. SDoH Report: Marvin D. Mitchell, Director of Case Management and Social Services at San Gorgonio Memorial Hospital in Banning, Calif., east of Los Angeles, reports on how to operationalize social determinants of health (SdoH) concepts.Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.

An older physician, practicing family medicine for 46 years, opens his door one day and finds an individual who says he works for the U.S. Department of Justice (DOJ), demanding to see medical records.In short order, the agent leaves the premises with charts, and later, the family physician finds himself facing the prospect of a trial by jury that the DOJ is demanding to quantify civil monetary fines and penalties. What could have possibly triggered this investigation?Reporting this developing story during this edition of Monitor Mondays is Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS). DeConda, who personally talked to the rural West Virginia physician, will report on the latest development in the case of a healthcare professional who plans to tell a jury of his peers that he didn’t swindle Medicare for money at their expense.Other segments to appear during the live broadcast include:RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group.Monday Focus: John K. Hall, MD continues his reporting on the now-infamous blog post of May 2, by Seema Verma, the Centers for Medicare & Medicaid Services (CMS) administrator. Hall reports that he expects that providers can expect more Recovery Audit Contractor (RAC) audits as a result of her blog. Hall is the founder of the Aegis Firm.SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SdoH), has the latest news on this trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listener Survey.Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on Split Shared Evaluation and Management EM Services.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.

Seema Verma, the Centers for Medicare & Medicaid Services (CMS) administrator, has raised the anxiety levels of healthcare providers with her blog post on May 2, 2019. With an ominous warning, Verna said that the RAC ADRs will be guided by the volume of claims a provider submits based on an undefined “type” of a claim. Does this signal that observation claims could be reviewed simply based on the volume of claims? Reporting this developing story during the next edition of Monitor Monday will be John K. Hall, MD, founder of The Aegis Firm. Other segments to appear during the live broadcast include:RAC Report: Healthcare attorney Knicole Emanuel will return to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group.SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SdoH), will have the latest news on this trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listener Survey.Monday Focus: Several different trends are simultaneously affecting physician payment even delimiting consideration to the Medicare program. Reporting on these trends and their impact on physician reimbursement and compliance requirements will the author, educator and consultant Duane Abbey, president of Abbey & Abbey Consultants, Inc.Risky Business: Healthcare attorney David Glaser will return to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.

Most likely your facility has been hit with claim denials for providing emergency department level-of-care coding. Such denials are not new, and in fact, RACmonitor and Monitor Mondays have been reporting about these denials for a number of years. But how can you and your team effectively deal with them? What tools and techniques are available? During this edition of Monitor Mondays, John K. Hall, MD, founder of The Aegis Firm and the newest member of the RACmonitor editorial board, will make his debut appearance on the broadcast to report on how payers are denying claims and how best to avoid them. Other segments to appear during the live broadcast include:RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group. False Claims Act Report: The U.S. Attorney’s Office in Chicago announced this week that a Chicago-area physical therapy center and four nursing facilities have agreed to pay $9.7 million to resolve civil allegations that they violated the False Claims Act by providing unnecessary services to increase Medicare payments. The owner of the skilled therapy service provider was excluded from the Medicare program for five years. On hand to explain the significance of this unusual case will be famed whistleblower Mary Inman, partner in the London office of Constantine Cannon. Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers. Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will make his Monday Rounds with another installment of his popular segment.

Forty Creek Whisky founder John K. Hall has kept a low profile since selling his distillery to Campari five years ago. He won dozens of awards for his whiskies at Forty Creek, and turned his startup into one of the best-selling Canadian whiskies around - earning him a place in Canadian Whisky history. Hall returned to the 2019 Victoria Whisky Festival for the first time since the sale to serve as the keynote speaker for the Canadian Whisky Awards dinner. In an exclusive interview with WhiskyCast's Mark Gillespie, he shared his thoughts on today's whisky business and whether he may make a comeback once his non-compete agreement with Campari expires later this year.

Forty Creek Whisky founder John K. Hall has kept a low profile since selling his distillery to Campari five years ago. He won dozens of awards for his whiskies at Forty Creek, and turned his startup into one of the best-selling Canadian whiskies around - earning him a place in Canadian Whisky history. Hall returned to the 2019 Victoria Whisky Festival for the first time since the sale to serve as the keynote speaker for the Canadian Whisky Awards dinner. In an exclusive interview with WhiskyCast's Mark Gillespie, he shared his thoughts on today's whisky business and whether he may make a comeback once his non-compete agreement with Campari expires later this year.