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Monitor Mondays

RACmonitor
Medicare
False Claims Act
Medicaid
Medicare Advantage
CMS
Telehealth
Artificial Intelligence
Healthcare Fraud
340B Drug Pricing Program
Healthcare Compliance
Racmonitor
Medicare Advantage Plans
Healthcare Audits
Affordable Care Act
Health Care Compliance
Centers For Medicare and Medicaid Services
No Surprises Act
Home Health Care
Prior Authorization
Social Determinants Of Health

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: racmonitor.medlearn.com/racmonitor/podcasts/

PublishesWeeklyEpisodes401Founded8 years ago
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Artwork for Monitor Mondays

Latest Episodes

Introducing FOCUS (Fraud Oversight through Careful Use of Statistics).  The U.S. Department of Justice (DOJ) has launched a new initiative in response to the surge in False Claims Act qui tam filings by data miners.

Today, roughly 45 percent of DOJ ... more

Healthcare compliance has entered the machine-learning era, and most organizations have not yet noticed. 

Providers are using artificial intelligence (AI) to generate documentation, surface reimbursable conditions, and tighten coding workflows. Regu... more

Documenting and coding sepsis has challenged virtually everyone in healthcare ever since Sepsis-3 redefined the condition in 2016 as a “life-threatening organ dysfunction due to a dysregulated host response to infection.”

Meanwhile, ICD-10-CM still ... more

The recent U.S. Supreme Court decision in Chiles v. Salazar doesn’t really close the case – but it also doesn’t really leave it open. 

The 8-1 decision, in which the nation’s highest court ruled that a Colorado ban on so-called “conversion therapy” ... more

Artificial intelligence (AI) is clearly here to stay – it’s now an integral part of healthcare. From coding and clinical validation to payer denials and appeals, AI is often a form of power upon which decisions are made by providers, payers, and audi... more

When the U.S. Supreme Court overturned Chevron deference, it promised to restore judicial independence and limit agency overreach. 

But in Medicare administrative proceedings, that promise remains unfulfilled. 

Tune in to the next upcoming live edi... more

National Doctor’s Day will bring a double whammy this coming Monday when the venerable Monitor Monday continues its recognition of the occasion with a pair of featured speakers: Drs. Drew Updike and Christopher Boyle.

The day of recognition took pla... more

Artificial intelligence (AI) is becoming part of how clinical documentation is reviewed across healthcare, from coding and clinical validation to payer denials and appeals. 

In many cases, AI is influencing decisions behind the scenes, even when it ... more

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Recent Guests

Folana Houston
Senior Legislative Affairs Analyst
Zelis
Episode: When Algorithms Audit Algorithms
Nicole LaMagna
Health care attorney
(Firm not specified)
Episode: Developing Story: Updating Sepsis Terminology in ICD-10-CM
Dr. John K. Hall
Physician and attorney reporting the lead story
Independent/Medical-Legal expert
Episode: SCOTUS Decision on Colorado “Conversion Therapy” Ban Leaves Much Left to Determine
Nicole Mowen
Healthcare attorney substituting for David Glaser
Fredrikson & Byron
Episode: SCOTUS Decision on Colorado “Conversion Therapy” Ban Leaves Much Left to Determine
Ronald Hirsch
Dr. Hirsch, MD, healthcare administrator and physician advisor
R1 Physician Advisory Solutions
Episode: A Close-Up Look at Healthcare AI “Sherpas”
Ed Roche
RAC Monitor Investigative Reporter
RAC Monitor
Episode: A Close-Up Look at Healthcare AI “Sherpas”
Jennifer Weinberg
Substitute host for Dr. Ronald Hirsch
R1 Physician Advisory Solutions
Episode: EXCLUSIVE: Huge Loophole Has Insulated Medicare Appeals
Drew Updike
Physician Advisor
Physician advisor (lead story)
Episode: Medical Double Dose: A Paradox on Doctor’s Day
Christopher Boyle
Physician Advisor
Physician advisor
Episode: Medical Double Dose: A Paradox on Doctor’s Day

Host

Chuck Buck
Host and Publisher of RAC Monitor, providing insights on regulatory news and information related to healthcare audits.

Top Education Podcasts

Talking Points

Recent interactions between the hosts and their guests.

Medicare Advantage and Prior Authorizations: The Good. The Bad. The Ugly.
Q: Under the two midnight rule, would you consider the blood pressure check as simply the normal triage process or count it?
The consensus indicated that the blood pressure check prior to midnight does start the two midnight clock.
Reign of Terror: Special Audit Report
Q: What should nurses do in a situation where they suspect patient injuries inflicted by ICE agents?
Nurses should consider the legal responsibilities around reporting such injuries, taking into account confidentiality and state laws regarding abuse reporting.
Docs Take Another Financial Hit
Q: Do you think it's harder to win at the ALJ level than it was five or ten years ago?
Yes, particularly because ALJs are now more likely to have their decisions reversed by the MAC.
Docs Take Another Financial Hit
Q: Last time telehealth was paid retroactively, can we assume that that will happen again or do we know?
Yes, we may expect that.
Providers Appear More Aggressive in Defending Revenue
Q: What do you think about the inaccurate report from the OIG regarding outpatient hospital stays?
David has been assisting a client on an OIG audit, and he highlighted the critical misunderstanding regarding outpatient hospital stays under Medicare rules, emphasizing that it is not permissible to have extended outpatient stays.

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Frequently Asked Questions About Monitor Mondays

What is Monitor Mondays about and what kind of topics does it cover?

Focuses on regulatory audit news and updates affecting the healthcare industry, particularly revolving around Medicare and Medicaid. Regularly features insights from healthcare attorneys, healthcare executives, and legislative analysts who contribute to discussions on compliance, audit processes, and legislative updates that impact providers and patients alike. The podcast also highlights major settlements and prevalent issues in healthcare billing and coding, offering practical advice for navigating the complexities of healthcare regulations.

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Which podcasts are similar to Monitor Mondays?

These podcasts share a similar audience with Monitor Mondays:

1. Talk Ten Tuesdays
2. What the Health? From KFF Health News
3. Tradeoffs
4. The ACDIS Podcast
5. An Arm and a Leg

How many episodes of Monitor Mondays are there?

Monitor Mondays launched 8 years ago and published 401 episodes to date. You can find more information about this podcast including rankings, audience demographics and engagement in our podcast database.

How do I contact Monitor Mondays?

Our systems regularly scour the web to find email addresses and social media links for this podcast. We scanned the web and collated all of the contact information that we could find in our podcast database. But in the unlikely event that you can't find what you're looking for, our concierge service lets you request our research team to source better contacts for you.

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What guests have appeared on Monitor Mondays?

Recent guests on Monitor Mondays include:

1. Folana Houston
2. Nicole LaMagna
3. Dr. John K. Hall
4. Nicole Mowen
5. Ronald Hirsch
6. Ed Roche
7. Jennifer Weinberg
8. Drew Updike

To view more recent guests and their details, simply upgrade your Rephonic account. You'll also get access to a typical guest profile to help you decide if the show is worth pitching.

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