PYA Webinar Recast

In this PYA Summer CPE Symposium session, John Cross discusses how AI is changing healthcare cybersecurity risk, compliance, and governance. The session covers the healthcare threat landscape, AI intrusion methods, AI defense tools, deepfakes, phishing, agentic AI, model drift, AI inventory, and vendor risk.

The presentation also addresses governance frameworks, HIPAA Security Rule considerations, AI risk assessments, incident response, MFA, tabletop exercises, and practical questions healthcare leaders should ask about AI cybersecurity readiness.

In this PYA Summer CPE Symposium session, Andrew Sizemore discusses the aligned assurance model and how it can help organizations coordinate assurance activities across the three lines of defense. The discussion covers the roles of finance, accounting, compliance, enterprise risk management, and internal audit in creating a more unified view of organizational risk.

Topics include assurance fatigue, duplicate testing, inconsistent risk assessments, siloed reporting, shared risk language, coordinated work plans, maturity planning, aligned assurance committees, and emerging risk response.

Artificial intelligence is already embedded across healthcare clinical, operational, compliance, privacy, security, revenue cycle, and administrative workflows. The challenge is not simply deciding whether to use AI. It is establishing the governance, accountability, human oversight, monitoring, and vendor controls needed to use it responsibly.

In HCRR #114, PYA Principal Valerie Rock, Senior Manager Miriam Murray, and Manager Erin Walker discuss AI inventories, risk assessment, human-in-the-loop oversight, embedded AI in EHR and vendor platforms, issue reporting, ongoing monitoring, and AI-specific vendor due diligence and contracting.

Webinar page: https://www.pyapc.com/insights/hcrr-114-webinar-managing-ai-tools-oversight-risk-and-compliance-in-practice/

CMS FY 2027 proposed rule changes could significantly affect reimbursement, quality reporting, and operational planning across hospitals and post-acute care settings. In this episode of Healthcare Regulatory Roundup, PYA's Kathy Reep and Carine Leslie break down the most important payment updates, quality program revisions, and compliance considerations providers should evaluate now. The discussion covers inpatient payment updates, Medicare Advantage integration into quality programs, revised reporting timelines, mandatory and proposed quality measures, and operational impacts across skilled nursing, inpatient rehabilitation, psychiatric, long-term acute care, and hospice settings. The presenters also explain where CMS is actively requesting industry feedback and why providers should closely evaluate the financial and staffing implications before final rules are issued. Healthcare executives, finance leaders, reimbursement professionals, compliance officers, and operational teams will gain a clear understanding of the proposed changes and the areas most likely to affect provider organizations in FY 2027.

This episode covers CMS enforcement activity and the downstream impact of Risk Adjustment Data Validation (RADV) audits on healthcare providers participating in Medicare Advantage. PYA experts explain how Medicare Advantage payments flow from CMS to health plans and providers, how risk adjustment drives reimbursement, and why provider documentation plays a critical role in compliance. The discussion also outlines current audit trends, documentation requirements, and practical strategies providers can use to reduce risk and respond to increasing regulatory scrutiny.

This episode covers the impact of the One Big Beautiful Bill Act (OBBBA) on Medicare DSH and the 340B drug pricing program. PYA presenters explain how new Medicaid eligibility requirements may affect hospital reimbursement, patient mix, and program eligibility, and outline strategies for accurately capturing Medicaid eligible days. The discussion also reviews recent 340B developments, including legal rulings, the status of the rebate model, CMS drug pricing surveys, and growing state-level legislative activity. Hospitals will gain a clearer understanding of current risks, operational considerations, and areas requiring proactive monitoring.

How hospitals can prepare for financial risk under the CMS TEAM model by turning claims data into actionable performance insights. This session explains how to quantify downside exposure, identify variation across episodes, and use dashboards and governance structures to drive measurable improvement.

This episode outlines the top 10 healthcare compliance risk areas managers need to know in 2026. PYA compliance leaders, Shannon Sumner, Miriam Murray, and Katie Croswell, discuss vendor oversight, cybersecurity and data breaches, artificial intelligence governance, digital transformation, healthcare real estate, EMTALA compliance, exclusion screenings, and reimbursement pressures. The session emphasizes practical risk mitigation strategies, including third-party risk management life cycles, AI inventory and governance structures, access monitoring, documentation standards, and continuous auditing. Listeners will gain a structured view of emerging and persistent compliance risks affecting healthcare organizations.

This episode examines how healthcare organizations can mitigate compliance and financial risk while conducting revenue integrity audits. PYA Principal Valerie Rock and Manager Kimberly Campbell walk through the auditing and monitoring cycle, with a focus on defensible sampling, documentation, and interpretation of results. The discussion covers:

• Probe audits versus statistically valid random samples
• Use of data analytics
• Understanding claims and financial error rates
• Navigating the Medicare 60-day rule when overpayments are identified
• Corrective actions
• Root cause analysis
• Internal controls needed to support sustainable compliance after an audit

This episode reviews new proposed rules, payment models, and regulatory guidance affecting healthcare organizations in early 2026. PYA Principals Martie Ross and Kathy Reep break down recent legislative activity, Medicare and Medicaid policy updates, and regulatory changes providers should be tracking as the year begins. Topics include:

• Medicare telehealth extensions
• Healthcare extenders
• Medicaid work requirements
• Medicare Advantage oversight
• 340B drug program developments
• Price transparency rules
• Interoperability initiatives
• Emerging alternative payment models

The discussion highlights how these changes may affect reimbursement, compliance, and operational planning.