The Compliance Guy

In this episode Sean takes on Templated Compliance Plans and the Do's and Don'ts! Taking the time to understand how compliance templates work for and against you is critical to establishing an effective program. The key takeaway from this podcast should be, “Don’t Be Lazy” if using a template… spend the time and effort on the front end to save you money, and your sanity on the back end.

What do you do when you receive "The Letter"? Everyone gets at least one from a payer/investigator/contractor that makes your belly gurgle and sends you searching for the Imodium AD! Take a listen to this episode for the Do's and Don'ts and how best to respond to the dreaded letter! 

In this episode I take on the lack of auditing standards in healthcare and push for standardization... There is no doubt we work in one of the most regulated and complex industries and at times it leads to a misinterpretation of Acts, Guidelines, Laws, Regulations and Statutes, and because of the complexities we deal with, it also leads to folks to taking shortcuts that in the long-run lead to critical problems. 

Take a listen and let me know if I have convinced you for why we need standards.

In this episode Sean and Terry provide a comprehensive list of acronyms in healthcare from the obvious to the obscure. There is also talk of The Show Friends, Sean's beard, and much more. There is also, a complete list of Sean and Terry's Acronyms available on LinkedIn on Sean's feed. 

In this 20 minute episode I discuss the dos and don'ts of handling an onsite investigation/audit and steps to take prior to something like that ever happening. 

In this episode I take on provider legibility. I know you are on an EMR but take a listen to this 13 minute episode to find out how a technical violation results in significant demands for refund by payors. I break down how payors try to use sampling and extrapolation without actually using the words but findings other synonyms to try to make it look less like they are doing something they should not be doing...   

In this episode Sean and Terry take on non-compliant providers and the liability it creates for "anyone" who knowingly submits claims in violation of the False Claims Act... Sean also gets to practice his Latin, which is quite entertaining! 

In this quick 15 minute episode Sean discusses the 2022 FCA increases for penalties and discusses the False Claims act and qui tam lawsuits. 

Joining Sean is special guests Attorney Colin Callahan of Flannery / Georgalis and Eric Rubenstein, Ret. OIG Agent of Advize Healthcare. The roundtable discussion will be Private Equity (PE) and the pitfalls of engaging both as the investor and as the portfolio company. 

There is ton to explore and we are sure you will walk away with a better understanding of how best to engage with PE! 

Don't forget to visit us at www.thecomplianceguy.com

In this episode Sean takes on the Eliminating Kickbacks in Recovery Act of 2018 (EKRA), the little known law passed in 2018... Congress enacted EKRA, a law to fight patient brokering and recovery profiteering. The law prohibits accepting or paying kickbacks for referrals to recovery homes, clinical treatment facilities, or laboratories. EKRA combats opioid related fraud.

Give me 20 minutes and I will give you EKRA tied up in a nice bow! 

Don't forget to visit us at www.thecomplianceguy.com