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Monitor Mondays

RACmonitor
Medicare
False Claims Act
Medicaid
Medicare Advantage
CMS
Artificial Intelligence
Telehealth
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/

PublishesWeeklyEpisodes418Founded9 years ago
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Artwork for Monitor Mondays

Latest Episodes

Government agencies routinely publicize allegations and settlements. But convictions are different – and far more consequential. When a court reaches such a judgment, the warning is no longer theoretical.

Understanding how and why entities or indivi... more

As expected, Monitor Monday continues to focus squarely on healthcare auditing and compliance.

During the next live edition of the venerable Internet broadcast, Monitor Monday will examine a range of compliance and auditing concerns associated with ... more

Artificial intelligence (AI) is dramatically reshaping healthcare by accelerating data analysis, auditing, and documentation. But while it appears to reduce provider burden, AI also strengthens medical necessity support.

What about compliance – and ... more

There has been a noticeable recent surge of activity among data-mining companies or individuals who analyze publicly available government data for potential signals of fraud, rather than the insiders who have traditionally served as relators under th... more

Program Update: CMS-2451-F has been published in the Federal Register. The proposed rule is effective Oct. 13, 2026. The recently posted rule prohibits federal and state Medicaid and CHIP program dollars from being spent on gender-affirming care for ... more

Much like the iconic TV commercials in which the late newscaster John Cameron Swayze would demonstrate on live television how the venerable Timex wristwatch could withstand relentless beatings and “could keep on ticking,” the venerable federal drug p... more

You wear a smartwatch as do so many other Americans. In fact, AI is transforming wearable healthcare devices from simple fitness trackers into powerful tools that collect, analyze, and share health information in real time.

During the next live edit... more

The Department of Justice (DOJ) recently announced “data sharing” agreements with the Centers for Medicare & Medicaid Services (CMS), the Department of Homeland Security (DHS) and the Federal Trade Commission (FTC). Many believe this latest developme... more

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Recent Guests

Nicole Moan
Health Care Attorney
Fredrikson & Byron
Episode: Complicated Compliance and Auditing That’s More Than Skin Deep
Veronica Richardson
Senior healthcare compliance consultant
First Class Solution
Episode: “Faster than a Speeding Bullet:” The Immediate Compliance Challenge Created by AI
Knicole Emanuel
Healthcare attorney
Poynter Spruill
Episode: “Faster than a Speeding Bullet:” The Immediate Compliance Challenge Created by AI
Kevin Chmura
CEO of Panacea Healthcare Solutions
Panacea Healthcare Solutions
Episode: The Latest Compliance Trap: Medicare Cost Reports
George Kelly
President, K Consulting Division of Panacea Healthcare Solutions
Panacea Healthcare Solutions
Episode: Recent Lawsuit: Racial Concordance in Healthcare Takes Center Stage
Dr. Drew Updike
Senior Health Care Consultant
RACmonitor
Episode: Recent Lawsuit: Racial Concordance in Healthcare Takes Center Stage
Pam Warren
Manager, regulatory billing audit
MaineHealth
Episode: AI and Auditing: Major Compliance Risks
Hamsa Mahendranathan
Whistleblower attorney
Whistleblower Attorney (lead story)
Episode: Surge in False Claims Act Violations Triggers New DOJ Initiative
Folana Houston
Senior Legislative Affairs Analyst
Zelis
Episode: When Algorithms Audit Algorithms

Host

Chuck Buck
Host of Monitor Mondays, RAC Monitor

Talking Points

Recent interactions between the hosts and their guests.

The Latest Compliance Trap: Medicare Cost Reports
Q: What is the significance of Worksheet S-12 in the Medicare cost report?
Worksheet S-12 is a signal that Medicare will increasingly rely on negotiated market rates and MA reimbursements to inform future fee-for-service payments, representing a fundamental shift in how inpatient reimbursement could be determined.
Complicated Compliance and Auditing That’s More Than Skin Deep
Q: What is the Stop Corporate Takeovers of Physicians Act trying to achieve, and why is it controversial?
It aims to curb private equity's influence in medical practice while preserving physicians' ultimate authority, which could clash with corporate ownership models and affect decision-making and hospital governance.
Avoiding the Next Claim Denial
Q: What makes Aetna's severity adjustment policy controversial from a regulatory and clinical perspective?
The policy changes inpatient stays into a per diem framework, potentially reducing protections and appeal rights, and creates a disconnect between clinical status and payment, which experts say could misrepresent patient severity and manipulate reimbursements.
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.

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Frequently Asked Questions About Monitor Mondays

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

A Monday-focused deep dive into healthcare regulation, billing integrity, and audit activity across Medicare, Medicaid, and related programs. Episodes blend legal, clinical, and policy perspectives to unpack CMS rules, OIG and DOJ actions, and rapid shifts in coding, enrollment, and appeals. A recurring strength is the practical guidance provided by a panel of healthcare attorneys, physician advisors, policy analysts, and investigative reporters, often anchored by live formats, sponsor updates, and real-world case discussions that translate complex regulations into actionable steps for providers, payers, and hospital leadership. The show stands out for its hands-on approach to audits, AI-driven compliance considerations, and timely coverage... more

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1. Talk Ten Tuesdays
2. The Oprah Podcast
3. The ACDIS Podcast
4. Freakonomics Radio
5. The Mel Robbins Podcast

How many episodes of Monitor Mondays are there?

Monitor Mondays launched 9 years ago and published 418 episodes to date. You can find more information about this podcast including rankings, audience demographics and engagement in our podcast database.

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What guests have appeared on Monitor Mondays?

Recent guests on Monitor Mondays include:

1. Nicole Moan
2. Veronica Richardson
3. Knicole Emanuel
4. Kevin Chmura
5. George Kelly
6. Dr. Drew Updike
7. Pam Warren
8. Hamsa Mahendranathan

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