The Compliance Guy

The Compliance Guy

By Sean M. WeissBusiness
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The Compliance Guy episodes

  • TCG Live with Clint Pulver / I Love It Here
    In this episode Clint Pulver sits down with Sean to discuss mentoring, leadership and creating that single moment in time! There are so many aspects to this discussion that leaders, regardless of their industry or how large or small their organization is will be able to take away and begin implementing immediately! The key to any successful business is your employees and once they can say "I Love It Here" you have achieved the ultimate level of sucess!
    Clints latest Book I Love It Here "How Great Leaders Create Organizations Their People Never Want to Leave" is available now at Amazon, Barns and Noble and where ever books are sold. Pick up your copy today!
    57 min
  • TCG with Terry Fletcher #TerryTuesday
    Terry Joins Sean to discuss the Office of Inspector General (OIG) Work Plan! As the new year approaches you need to be prepared to conduct internal audits and the best thing to do is create an audit elements guide and set yourself up for success:
    Topics of Discussion:
    1. Breakdown of the OIG Work Plan
    2. Audits of Emergency Room Physician Evaluation and Management Services
    3. Audits of Autoimmune Disorder drugs for self-injection and/or infusion
    4. Urine Drug Testing (UDT) for SUD's
    5. Place of Service for Physician Services when Beneficiary is Inpatient (Part A)
    This episode is jam packed with critical information and analysis to ensure you remain at the top of your compliance game!!!
    1 hr 1 min
  • TCG The Unified Program Integrity Contractor (UPIC)
    It is #TerryTuesday and that can only mean my good friend Terry Fletcher is joining me for our special segement! This week we are tackling the UPICs and clearing up misperceptions and misunderstandings for who they are and what they actually do! You do not want to miss this one...
    30 min
  • CMS Omnibus Rule and OSHA's Emergency Temporary Standard (ETS)
    Brianna Santolli, ESQ and Terry Fletcher join Sean to discuss the realse on November 5, 2021 The CMS Interim Final Omnibus Rule followed by the OSHA ETS were released... These have been declared as "Mandates" but since their issuance there have been several legal maneuvers to block these mandates from being carried out. On Thursday November 11, 2021 several states led by Texas file a motion to block the mandates with the 5th Circuit Court out of New Orleans, LA. The filing was successful (Read my blog post on LinkedIn – Saturday November 13, 2021). On the same day the Department of Justice (DOJ) vowed to fight the block issued by the 5th to see that the mandates are enforced.
    Several states have had their measures blocked as well declaring them unconstitutional! The legal battles are far from over! What is contained in this podcast are the facts of the mandates at the time of release!
    54 min
  • TCG Compliance Roundtable
    In this episode Scott Kraft, Stephanie Allard and J. Paul Spencer join Sean to discuss the 2022 Physician Fee Schedule Final Rule, Evaluation and Management Service pitfalls in 2021 tied to the new guidelines and changes to the Split/Shared Services. Lots of great information that all healthcare professionals need to be aware of!
    There was also a discussion of Chronic Care Management (CCM) Services and Incident-to, which got quite animated! Great episode with great guests and outstanding audience participation!
    1 hr 1 min
  • TCG Live with Karen Baird / Tennessee Medical Association
    Karen joined Sean on this episode to discuss the TN Association and their incredible government and legal advocacy, comprehensive education opportunities, and the fact they are pioneers with their partnerships with the biggest insurers and governmental payers. Whether you are in the state of TN or not, you will want to hear what Karen and Sean discuss because it just may help you in your state!
    41 min
  • TCG Live with Jared Walker, Founder / Dollar For
    Jared Walker, Founder of Dollar For (www.dollarfor.org) joined me for this critical discussion on the medical debt crisis! Jared inspires me every single day and he should inspire you as well...
    Nationally, 17.8 percent of people with a credit report as of 2020 had medical debt in collections, and 13 percent had accrued debt in the prior year but were not yet in collections. Of those who had medical debt, the average amount was $2,424 last year. These findings are roughly in line with previous Census Bureau estimates.
    The South has the most people with medical debts, or 23.8 percent of all residents, and the largest average amounts past due, as of 2020. The Northeast had the lowest debt loads, with 10.8 percent of individuals with credit reports in arrears, and the smallest unpaid tabs. People living in low-income areas owed the most, while those residing in high-income regions owed the least.
    States that expanded Medicaid in 2014 saw a decline in the average yearly accrual of medical debt through 2020 that was 34 percentage points greater than states that did not expand their Medicaid rolls.
    Almost all income groups in non-Medicaid expansion states saw their medical debts rise annually from 2009 to 2020. The poorest communities were most affected: In 2020, they added $836 on average in new medical debt per capita, up from an annual amount of $630 in 2009.
    Between 2009 and 2020, total medical debt in collections decreased less than reductions in nonmedical debt. By 2020, individuals had more medical debt in collections than they had in debt in collections from all other sources combined, including credit cards, phone bills, and utilities.
    The above statistics provided by the Stanford Institute for Economic Policy Research who indicated that the nationwide medical debt estimate is probably larger than $140 billion.
    53 min
  • TCG with Terry Fletcher - TPE Audits
    In this episode of TCG, Terry joins Sean to discuss the re-launch of the TPE Audit Program by The Centers for Medicare and Medicaid Services (CMS)... There have been some significant changes to the process so hang around until the end to make sure you capture all the critical information to ensure when you get "The Letter" you are prepared.
    45 min
  • Season 2 TCG "Leveling the Playing Field"
    Welcome to season 2 of TCG. In my first episode we lay out how to level the playing field with payers and we did this! Here is what is included in this episode:
    1. Ex-post Facto Guidelines and Laws
    2. Understanding Payer Participation Agreements
    3. Breakdown of Clinical Judgement, Medical Necessity, and The Treating Physician Rule
    4. AMA Definition of Risk When Clinical and Non-Clinical Reviews are Deployed by Payors
    5. Breakdown of Reasonable, Appropriate and Necessary
    40 min
  • TCG with Clint Pulver
    This was an incredibly special podcast for me as it is not often you get to say, "I got to interview an Emmy Award Winner"! My discussion with Clint Pulver (yes, that Clint Pulver) while short, the impact of his message will linger long after you reach the end!
    19 min

About The Compliance Guy

From the publisher's feed

Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals.