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The misuse of Modifier 25 can result in overcompensation if the physician is being compensated through a wRVU productivity model. In this episode, Captain Integrity Bob Wade lays out the connection between Modifier 25 and wRVUs as they relate to the Stark Law. Hear what questions to ask when it comes to Modifier 25, how to document separateness & significance, the connection between auditing for Modifier 25 and the Stark Law, the 4 criteria to use with Modifier 25, and the origin of Going the Extra Mile. Learn more at CaptainIntegrity.com 

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Don’t shoot the messenger. In this episode, Captain Integrity Bob Wade explores the nature of delivering bad news as a Compliance Officer & beyond. Hear how to deliver bad news, why you should soften the soil, how to use the sandwich approach when delivering bad news, the dangers of sugarcoating, and the history of the phrase Don’t Shoot the Messenger. Learn more at CaptainIntegrity.com 

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Auditor: you are not a Compliance Officer. In this episode, Captain Integrity Bob Wade dives into the complementary roles of Compliance Officer and Auditor. Hear the difference between the two roles, what each position is responsible for, why the roles are separate & distinct, the history of the Charles Horton Cooley looking-glass self quote, and some notable Hamilton lyrics. Learn more at CaptainIntegrity.com 

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Audit yourself. In this episode, Captain Integrity Bob Wade tackles the 2025 healthcare enforcement priorities with Brook Andrews, Partner at Nelson Mullins. Hear why healthcare enforcement is not going away, how the government’s healthcare enforcement tools will continue to get better, how to build a culture of transparency, who healthcare enforcement is targeting, and the parable of the blind men and the elephant. Learn more at CaptainIntegrity.com 

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If medical staff funds are in a hospital account, the Stark Law applies. In this episode, Captain Integrity Bob Wade details medical staff funds as they relate to the Stark Law. Hear when the Stark Law applies, why the medical staff funds are restricted, what to consider if the medical staff funds are not in a hospital account, the risks when it comes to medical staff funds, and  why this is a controversial topic. Learn more at CaptainIntegrity.com 

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If you’re paying your doctor for an hour of service, you better make sure your doctor is working an hour of service. In this episode, Captain Integrity Bob Wade breaks down what happens when financial arrangements exceed Fair Market Value (FMV). Hear why it’s important to keep tabs on your doctors, why monitoring is such a key component of compliance, what to do if financial arrangements exceed FMV, a case example of unethical billing practices, and the Top 10 PSA that inspired this episode. Learn more at CaptainIntegrity.com

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Healthcare providers should be concerned. In this episode, Captain Integrity Bob Wade explores the new DOJ and HHS False Claims Act Working Group targeting healthcare fraud with Knicole Emanuel, Partner at Nelson Mullins. Hear why you should review your compliance program, reassess your risk exposure, consider voluntary disclosure, the areas the working group is targeting, and why this is a paradigm shift for the healthcare industry. Learn more at CaptainIntegrity.com 

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The larger the country, the longer it takes to get trials approved. In this episode, Captain Integrity Bob Wade explores how compliance works for national & international clinical trials with Julio Martinez-Clark, CEO of bioaccess. Hear how clinical research is global, why some countries approve trials quicker, why patients in developing economies need to have access to these trials, how countries differ with their regulatory requirements, and the hottest topics in compliance. Learn more at CaptainIntegrity.com 

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The best defense is a good offense. In this episode, Captain Integrity Bob Wade discusses the dreaded UPICs (Unified Program Integrity Contractors) with Harriett Wall, President & CEO of LW Consulting. Hear why a UPIC audit is a very serious matter, why you need to organize your team as soon as possible, how to put together a robust compliance plan, who could be the subject of a UPIC audit, and how the appeal process works. Learn more at CaptainIntegrity.com

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Attackers only win when you have no choice left. In this episode, Captain Integrity Bob Wade breaks down the importance of cybersecurity in healthcare & compliance with Matthew Toussain, Founder of Open Security. Hear how to focus on the basics, why you shouldn’t trust anyone, how to know your risk and the enemy, how to stay ahead of cybersecurity attacks, and Matthew’s background in the Air Force. Learn more at CaptainIntegrity.com