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Monitor Mondays

RACmonitor

Join Chuck Buck every Monday when he welcomes RACmonitor contributing editors and special guests for the latest regulatory audit news and information from CMS, OIG and OMHA. And gain valuable context and perspective that can only be found when you’re listening to the long-running and popular Monitor Mondays. Register to attend live here: https://medlearn.com/racmonitor/podcasts/

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  1. More False Claim Audits are Coming 26:24
  2. Understanding the Consequences of Low-and No-Value Healthcare 26:31
  3. Feds Initiate $25 Million Whistleblower Program 26:20
  4. Compliance: The Underpinnings of ACDIS 27:13
  5. National Case Management Week: The Inside Story of What’s Driving Outcomes 37:03
  6. DOJ Announces $385 Million Settlement to Resolve False Claims Allegations over Abbott Laboratories Baby Formula 30:52
  7. Convicted: The Cases Every Compliance Leader Should Know About Now 26:52
  8. Complicated Compliance and Auditing That’s More Than Skin Deep 29:24
  9. “Faster than a Speeding Bullet:” The Immediate Compliance Challenge Created by AI 27:05
  10. Purging the Surge of Data Miners: A New FCA Program from DOJ 26:53
  11. Gender Affirming Care (CMS-2451-F): Still Proposed 29:11
  12. Buffeted, Badgered, Bruised and Bleeding: The Battered 340B Drug Reforms 26:45
  13. Latest Privacy Issue: AI-Powered Wearables 28:11
  14. The One Note Samba: DOJ Data Sharing 28:05
  15. Healthcare Today: Status Quo Bias 26:51
  16. The Latest Compliance Trap: Medicare Cost Reports 30:42
  17. Preventing Denials: The Role of Facility-Based Clinical Definitions 31:04
  18. Behavioral Health: Avoiding Common Pitfalls 31:48
  19. Avoiding the Next Claim Denial 29:01
  20. Seeking Compliance Across the Revenue Cycle 26:42
  21. Who will Blink First? 340B Health at Center Stage as Controversy Continues 29:28
  22. Recent Lawsuit: Racial Concordance in Healthcare Takes Center Stage 33:37
  23. AI and Auditing: Major Compliance Risks 34:24
  24. Surge in False Claims Act Violations Triggers New DOJ Initiative 26:06
  25. When Algorithms Audit Algorithms 28:48
  26. Developing Story: Updating Sepsis Terminology in ICD-10-CM 29:25
  27. SCOTUS Decision on Colorado “Conversion Therapy” Ban Leaves Much Left to Determine 25:10
  28. A Close-Up Look at Healthcare AI “Sherpas” 27:15
  29. EXCLUSIVE: Huge Loophole Has Insulated Medicare Appeals 30:14
  30. Medical Double Dose: A Paradox on Doctor’s Day 33:46
  31. Understanding AI Interpretation in Healthcare 29:39
  32. Aetna Latest to Acquiesce Amid FCA Allegations 30:40
  33. Autonomous Coding: A New Reality 26:50
  34. Lesson Learned: Navigating the Ever-Expanding Scope of Prior Authorization 29:33
  35. CMS Launches CRUSH: A New Anti-Fraud Program 30:42
  36. Medicare Advantage and Prior Authorizations: The Good. The Bad. The Ugly. 29:48
  37. Did CMS Draw the Right Conclusion about Aetna’s Severity Policy? 30:23
  38. Reign of Terror: Special Audit Report 26:27
  39. Docs Take Another Financial Hit 30:02
  40. $556 million False Claims Settlement Rattles Many in Healthcare 30:35
  41. CMS Blocks Gender Affirmative Care 31:10
  42. The Whistleblower Update 30:37
  43. The Fatal Blow: “Statistically Valid Extrapolation” 29:25
  44. The Feds Blow the Whistle: A $45 Million Wound Care Settlement 31:50
  45. Providers Appear More Aggressive in Defending Revenue 27:44
  46. New Audit Traps Revealed in the 2026 Medicare Physician Fee Schedule 28:24
  47. New Sepsis Definition Could Help You Achieve Denial Avoidance 30:12
  48. DME Supplier Pays $37 Million to Resolve FCA Allegations 30:12
  49. A New Drug Crisis Soon Facing American Hospitals 31:09
  50. The Lowdown on the Shutdown 28:18