Telehealth remains one of the most dynamic and closely watched areas in healthcare compliance. 

In this episode of Compliance Conversations, CJ Wolf welcomes back telehealth compliance expert Keisha Wilson, founder of KW Advanced Consulting, for a timely discussion on the latest telehealth developments, including newly extended flexibilities, evolving documentation requirements, and the audit risks organizations cannot afford to ignore. 

With key telehealth provisions now extended through December 31, 2027, many providers may feel a sense of relief. But as Keisha explains, the extension of flexibilities does not eliminate the complexity. In many ways, it raises the stakes for compliance teams, coders, administrators, and revenue cycle leaders who need to ensure their organizations are using telehealth appropriately, documenting correctly, and staying aligned with changing payer and regulatory expectations. 

During the conversation, CJ and Keisha break down what the latest legislative changes mean in practical terms, including the continued use of the patient’s home for telehealth services, ongoing allowances for audio-only services in certain situations, and continued telehealth participation for FQHCs, RHCs, physical therapists, occupational therapists, speech-language pathologists, and audiologists. 

They also discuss where organizations may be most vulnerable, including: 

• Documentation requirements for audio-only visits 
• Appropriate use of modifiers and place of service codes 
• Payer-specific and state-specific telehealth variation 
• Behavioral health in-person visit requirement delays 
• Virtual direct supervision and the compliance concerns surrounding Incident To billing 
• Remote patient monitoring oversight issues 
• Medical necessity concerns 
• Fraud, waste, and abuse risks in telehealth delivery 

Keisha also shares practical recommendations for staying current, including which websites and resources compliance leaders should monitor as telehealth rules continue to evolve across Medicare, Medicaid, commercial payers, and state laws. 

If your organization provides telehealth services, this episode offers a valuable look at the operational and compliance details that deserve closer attention in 2026. 

Episode Resources: 

• KW Advanced Consulting:  https://kwadvancedconsulting.com/telehealth-in-2026-and-beyond-what-the-latest-extensions-mean-for-healthcare/ 
• Center for Connected Health Policy (CCHP):  https://www.cchpca.org/ 
• American Telemedicine Association (ATA): https://www.americantelemed.org/ 

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Medical decision making shouldn’t feel like a coding puzzle, and your documentation shouldn’t read like a template checklist. 

In this episode, CJ Wolf is joined by Amanda Reikowsky, a coding quality audit & education supervisor at Hackensack Meridian Health and founder of CodeWise Solutions, LLC, to break down what MDM documentation should look like today—and why the best notes focus on the story and rationale behind care. 

What you’ll learn 

• The most common MDM documentation gaps auditors see, and how to fix them 
• How to connect diagnoses to plans so each condition is clearly managed 
• Why “reviewed results” or “discussed with specialist” isn’t enough (and what to add) 
• How to document risk based on patient-specific factors (COPD, CKD, diabetes, pregnancy, and more) 
• How the E/M guideline shift changed what matters, and why templates need to catch up 

Why this matters 

Over-documentation and cloned notes don’t just create compliance risk—they make it harder for clinicians to find what’s relevant, and harder for coders and auditors to validate the level of service. Clear clinical reasoning protects patient care, supports accurate coding, and strengthens defensibility. 

Reach out to Amanda at [email protected] or visit her website at www.codewisesolutionsllc.com. 

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Mentorship can be the difference between feeling stuck and building a career with real direction. In this episode of Compliance Conversations, CJ Wolf is joined by Barbara Shaw, a seasoned healthcare coding, auditing, and risk adjustment professional who has made mentoring new coders a meaningful part of her work, especially through her involvement as an AAPC local chapter officer. 

Barbara shares why mentorship is so rewarding, how she structures mentoring relationships in a realistic way, and what she’s learned about helping people move from “interested” to “ready.” 

What you’ll learn 

• How mentorship actually works: what to expect from mentor/mentee check-ins and career guidance 
• Where to find support: why AAPC chapters are an underrated resource for new coders 
• Choosing your next step: credentials, specialties, and how to decide what’s worth pursuing 
• Remote work expectations: the accountability and discipline required to thrive long-term 
• Sustaining professional growth: avoiding plateaus by taking ownership of development—and giving back 

About Barbara Shaw 

Barbara Shaw brings decades of hands-on experience across coding, auditing, and population health. She spent 20 years working in OB/GYN practices and later went on to build and lead a risk adjustment auditing team. During her time at Duke University, she used Healthicity to support audit workflows, with a focus on OB/GYN, emergency department, and risk adjustment audits. 

Her career has also included work with several Medicare Advantage payers and ACOs. Today, she is part of the team at Mass General Brigham, where she is happy to be back in Population Health, focusing on outpatient CDI. 

Barbara is a strong supporter of AAPC and is actively involved at the chapter level. She frequently speaks at local chapter meetings and currently serves her local chapter as the education officer, helping support and mentor the next generation of coding professionals. 

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Compliance risks don’t always start in obvious places—and that’s what makes them dangerous. 

In this episode of Compliance Conversations, host CJ Wolf talks with Amy Bailey of HBE Advisors about the real-world compliance failures she sees most often across hospitals and physician groups nationwide. Drawing on decades of experience with investigations, self-disclosures, and Corporate Integrity Agreements, Amy shares practical insights compliance leaders can apply immediately. 

In this episode, you’ll learn: 

• Where compliance blind spots commonly occur—and why frontline teams matter 
• How missed or misunderstood payer correspondence can escalate into enforcement actions 
• What works (and what doesn’t) when gaining physician buy-in 
• Why traditional audit approaches miss documentation and behavior risks 
• Key enforcement and audit trends shaping compliance priorities today 

Whether you’re managing audits, responding to payer inquiries, or building a proactive compliance strategy, this episode delivers candid insights you won’t find in a policy manual. 

You can also see Amy at the upcoming HCCA 30th Annual Compliance Institute where she’ll be presenting  “Bridging Boundaries: Strengthening Collaboration Between Healthcare Organizations, Independent Review Organizations, and OIG Monitors.” 

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Refunds and overpayments sit at the intersection of compliance, finance, and legal risk. In this episode of Compliance Conversations, CJ Wolf speaks with David Glaser, healthcare attorney and in Fredrikson’s Health Law group, about how organizations can navigate refund decisions with greater confidence and clarity. 

Drawing from years of advising providers nationwide, David explains: 

• The difference between binding law and non-binding guidance 
• Navigating refunds 
• How far Medicare can actually look back on claims 

This practical, real-world conversation is essential listening for compliance, audit, revenue integrity, and legal professionals. 

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In this episode of Compliance Conversations, host CJ Wolf sits down with Jill Fallows Macaluso, Corporate Vice President and Chief Compliance Officer at Novo Nordisk, to explore how ethical culture, psychological safety, and empowered risk-taking can transform compliance from a regulatory obligation into a strategic asset. 

Jill shares insights from more than two decades in a highly regulated industry, discussing how organizations can move beyond check-the-box compliance and build cultures that foster trust, innovation, and sustainable business results. 

In this episode, you’ll learn: 

• Why ethical culture consistently correlates with stronger business performance 
• How psychological safety strengthens both compliance and innovation 
• What “risk-based decision-making” really looks like in practice 
• How leaders can empower teams without sacrificing accountability 
• Why inclusion is foundational to ethical, high-performing organizations 

Whether you’re a compliance officer, legal leader, or executive, this conversation offers practical guidance for building a culture where people feel safe to speak up, take smart risks, and do the right thing. 

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In this episode of Compliance Conversations, healthcare compliance expert Jessica Zeff, the Founder & CEO of Simply Compliance, shares real-world insight into why structured, electronic case management is essential for demonstrating compliance, managing risk, and responding efficiently to audits and investigations. 

What You’ll Learn 

• What compliance case management actually looks like in practice 
• Why consistency and categorization matter for risk analysis 
• Common mistakes organizations make when handling compliance cases 
• How case management supports audits, investigations, and leadership reporting 
• Why even basic systems are better than none 

Who Should Listen 

Compliance officers, privacy professionals, legal teams, audit teams, and anyone responsible for managing compliance or incident investigations.

 

About Jessica Zeff: 

Jessica Zeff is the CEO & Founder of Simply Compliance, a healthcare compliance consulting firm specializing in regulatory compliance, privacy, and risk management. A strategic leader with nearly 25 years of experience, Jessica is skilled in building compliance programs, translating complex regulations into actionable strategies, and mitigating compliance risks through proactive program development and data-driven decision making. 

Jessica is also an experienced speaker and educator, having delivered presentations and webinars for the Health Care Compliance Association (HCCA) and numerous healthcare partners on topics ranging from privacy and data security to compliance risk management. She is the creator and host of the Compliance Deconstructed podcast, where she explores practical approaches to healthcare compliance, and the author of the popular blog series Olivia’s Compliance Diaries, which brings real-world compliance lessons to life through storytelling. 

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Critical care coding isn’t just about time at the bedside. In this new episode of Compliance Conversations, CJ Wolf and Maya Turner discuss how recent CPT® guidance expands what’s billable, from telehealth consults to pre-arrival care coordination. 

Key Takeaways: 

• When critical care starts (and where it doesn’t) 
• CPT® vs. CMS Guidance— and what happens when they differ 
• How to handle transport, telehealth, and overlapping E/M services 
• Ways to help providers feel recognized — even when the answer is “no” 

Here is a link to the OIG audits referenced in the episode. 

You can read Maya’s book, Billable: The Revenue Cycle Professional's Guide to Branding, for more insights. 

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As federal deadlines, a shutdown, and stalled legislation churn the rules, telehealth coverage looks different across Medicare, Medicaid, and commercial payers. In this episode, CJ Wolf, MD and Keisha Wilson (Founder/CEO of KW Advanced Consulting) breaks down what’s actually covered right now—and how to stay compliant without disrupting care. 

You’ll learn: 

• Where Medicare telehealth reverted and where behavioral health remains an exception 
• How to use ABNs correctly (and why timing is everything) 
• Why payer & state policies diverge—and how to operationalize a payer matrix 
• The must-have front desk workflow: eligibility, POS, modifiers, codes 
• HIPAA platform requirements and documentation tips 

Who should listen: Compliance leaders, revenue cycle teams, practice managers, telehealth program leads, behavioral health providers. 

Recorded: October 30, 2025 (details current as of this date) 

You can also tune into our previous Compliance Conversations episode with Keisha, The ABCs of ABNs. 

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Headlines change. Your mandate doesn’t.  

In this Compliance Conversations episode, CJ Wolf, MD, and Brian Burton, Healthicity Chief Compliance & Privacy Officer, cut through the noise to show how to keep programs objective, patient-first, and audit-ready—even amid shutdowns, delayed rules, and shifting priorities. 

What you’ll learn 

• Enforcement reality check: Why fraud, waste, and abuse actions keep moving—and how to prepare. 
• Backlogs & timing: Practical impacts of shutdowns on OCR complaints, self-disclosures, and CIAs. 
• Medicare Advantage focus: Signals that MA audits are scaling and what that means for you. 
• Telehealth decisions: “Hold or bill?” Cash-flow, denial risk, and documenting your rationale. 

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