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The Compliance Guy
By Sean M. WeissBusiness
The Compliance Guy episodes
- Episode 3 - P1In this segment Sean sits down with Amanda L. Waesch of Brennan Manna and Diamond (BMD) to discuss the November of 2020 Final Rule on Stark Law and Profit/Gain Sharing. This segment is a must for all provider groups, hospitals and health systems!35 min
- DOJ Evaluation of Corporate Compliance ProgramsIn this segment Sean discusses the DOJ Criminal Division's Evaluation of Corporate Compliance Programs. Sean breaks down various aspects of what most consider a prosecutors playbook. A discussion of conducting internal audits and developing corrective actions to ensure listeners are intune with what is required ensures risk mitigation.40 min
- Creating and Structuring Winning AppealsIn this session Sean discusses appeal strategies with a central focus on Medicare. Appeals are technical in nature but are a lost art and this podcast you'll understand how and when to appeal to the different levels. Specific terms are defined, forms are addressed, and processes for the 5-levels are broken down. A full explanation of the structural changes put forth in the 2017 final rule that were not well explained is finally provided...If you have ever struggled with appealing claims to Medicare then this is a podcast you do not want to miss.1 hr 5 min
- Conducting a Fraud InvestigationFraud, Waste and Abuse continue to plague the healthcare system and drive consumer prices and medical practice costs sky-high. In this episode Sean discusses the ins and outs of conducting a fraud investigation in addition to various laws, statutes, regulations and Acts as well as requirements for a corrective action plan.39 min
- A Compliance Officer Roadmap to Self-Disclosure ProtocolIn this session Sean discusses how to determine whether a self-disclosure protocol through the OIG is the right decision for your medical practice/organization. This is an in-depth look into a complex process to ensure you make the right decision.50 min
- Audit Escalation and Non-Retaliation PoliciesSean discusses the importance of properly structured policies to ensure medical organizations position themselves to drive their "Culture of Compliance" and foster compliance with their employees. Sean also offers some outstanding giveaways to you the listener.27 min
- Stand Your Ground With PayersDuring this 45 minute podcast Sean provides providers and their staff the areas they need to focus to ensure a level playing field with payers. The areas of concentration are:1. Ex Post Facto Laws and Guidance on post-payment reviews2. Medical Necessity including Clinical Judgement and The Treating Physician Rule3. Sources and Authoritative Guidance; where to look and what to avoid4. Judgement Error and Provider Without Fault46 min
- Episode 2 OIG, Price Transparency and COVID-19In this episode we are joined by former Special Agent for the Office of Inspector General Eric Rubinstein, Chief Innovation Officer of OncoSpark Jordan Johnson and the Employmeny Law After Hours Podcast Team (Monica Andress and Bryan Meek)1 hr 26 min
- The Compliance Guy Live - Episode 1https://www.youtube.com/watch?v=won0yKn6HUY&ab_channel=ComplianceGuyLIVE1 hr 3 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.
The show features interviews of industry leaders, government officials, and others helping to shape the healthcare landscape.
Sean M. Weiss (AKA – The Compliance Guy) has been an industry respected name for more than 25-years. A physician and health system advocate, Sean engages with clients to ensure a “level-playing-field” and due process when allegations and/or accusations of impropriety are leveled by a payor or government investigation agency.
When Sean is not engaging in administrative, civil and criminal matters on behalf of more than 30 nationally recognized law firms and clients, he is serving as a third-party compliance officer for a dozen organization across the country ranging in size and specialty to ensure a “Culture of Compliance”!
Sean is a proud member in good-standing with the National Society of Certified Healthcare Business Consultants (NSCHBC), American Health Lawyers Association (AHLA), National Alliance of Medical Auditing Specialists (NAMAS), and the American Academy of Professional Coders (AAPC). Sean holds (CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC, CMC, CMIS, CMOM) national certifications from the Health Care Compliance Association, The National Alliance of Medical Auditing Specialists, The American Academy of Professional Coders and Practice Management Institute.