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://racmonitor.medlearn.com/racmonitor/podcasts/

  1. 5 days ago

    The One Note Samba: DOJ Data Sharing

    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 development might be the most consequential enforcement shift in twenty years. DOJ can now run analytics directly against CMS claims data, DHS travel records, and FTC complaint data, all in one shared environment. During the next live edition of the venerable Monitor Monday Internet broadcast, senior healthcare analyst Frank Cohen, program’s special guest, says it’s the data sharing agreement has changed everything. Register now to listen and learn when Cohen explains why the idea of a defensible pattern just got a lot bigger. It’s important that you need to know what this means for your data. The broadcast will also include these instantly recognizable segments: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Adam Brenman, legislative affairs liaison for Zelis, will report on current healthcare legislation.

  2. 27 Jul

    Healthcare Today: Status Quo Bias

    Maybe it’s the summer doldrums that keep otherwise rational people from taking a chance—especially when better alternatives may be available. But according to physician and attorney Dr. John K. Hall, the special guest on the next live edition of Monitor Mondays, some individuals prefer to maintain the status quo rather than pursue a potentially better approach. Case in point: Aetna’s recent discharge policy. Beyond the policy itself, which seems to be causing consternation among some hospitals, are there other examples? Listen to the special broadcast Monday, July 27, at 10:00 a.m. EST. The broadcast will also include these instantly recognizable segments: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Adam Brenman, legislative affairs liaison for Zelis, will report on current healthcare legislation.

  3. 20 Jul

    The Latest Compliance Trap: Medicare Cost Reports

    Who would have thought that the otherwise fairly simple Medicare Cost Report could be a serious compliance trap? Some are calling the new Medicare report worksheet a possible precursor to the most significant reimbursement change in decades. For 2026, the Centers for Medicare & Medicaid Services (CMS) will require hospitals to report Medicare Advantage (MA)-negotiated reimbursement by Medicare Severity Diagnosis-Related Group (MS-DRG). The implications extend far beyond compliance, requiring coordination across reimbursement, finance, revenue cycle, managed care, coding, IT, and analytics. Listen and learn during the next edition of Monitor Mondays when the CEO for Panacea Healthcare, Kevin Chmura, unpacks Worksheet S-12. You’ll quickly discover the finer details of the looming fundamental shift toward market-based reimbursement, and how forward-thinking hospitals can turn this change into a strategic advantage. Broadcast segments will also include these instantly recognizable features: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on current healthcare legislation.

  4. 13 Jul

    Preventing Denials: The Role of Facility-Based Clinical Definitions

    Payer-driven clinical validation is a common reason given by payers to remove ICD-10-CM/PCS diagnosis and procedure codes affecting reimbursement or quality-based payment models (e.g., the Centers for Medicare & Medicaid Services/CMS Hospital-Acquired Conditions), even though these codes are based on the documentation of licensed providers. During the next Internet broadcast of the venerable Monitor Monday, Dr. James S. Kennedy of CDIMD will propose a strategy that engages payers in how patient conditions or treatments should be defined, diagnosed, and documented, elevating the practice of medicine and confronting denials that are often based on misinterpretations of current clinical literature. Broadcast segments will also include these instantly recognizable features: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Cate Brantley, legislative affairs liaison for Zelis, will report on current healthcare legislation.

  5. 6 Jul

    Behavioral Health: Avoiding Common Pitfalls

    Behavioral health services continue to face heightened payer scrutiny. The result: inaccurate documentation, coding, and compliance issues. Panacea Healthcare recently hosted a webinar that focused on three high-risk areas: relative to Behavioral Health–telehealth, psychotherapy with evaluation and management (E&M) services, and the Collaborative Care Model (CoCM). Special guest George Kelly is expected to summarize these issues while outlining the common compliance pitfalls, documentation requirements, coding best practices, and audit risks associated with each service. Broadcast segments will also include these instantly recognizable features: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Adam Brenman, legislative affairs analyst for Zelis, will report on current healthcare legislation.

  6. 29 Jun

    Avoiding the Next Claim Denial

    There’s a method by which providers can avoid the snare of the latest claim denial strategy to garner attention. Much has been written about the Aetna policy for its “severity inpatient payment” element. Yet almost daily, providers appear to be turning to trusted sources to avoid pitfalls. And that is why the producers of RACmonitor’s Monitor Mondays have invited physician and attorney Dr. John K. Hall to serve as special guest during the next edition of the venerable weekly national podcast. During this remarkable live Internet broadcast, Dr. Hall will unpack the issues that seem to flummox payers, resulting in a variety of actions, ranging from recoupment to reimbursement at lower levels (i.e. “observation” rates). Broadcast segments will also include these instantly recognizable features: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Cate Brantley, legislative affairs analyst for Zelis, will report on current healthcare legislation.

  7. 22 Jun

    Seeking Compliance Across the Revenue Cycle

    Motivated by the notion that healthcare providers are seeking compliance solutions across the revenue cycle, the producers of Monitor Mondays have invited the CEO of Panacea Healthcare Solutions to serve as the special guest during the next upcoming broadcast. Introducing Kevin Chmura. For more than 25 years, Mr. Chmura has been at the forefront of major healthcare vendors as they, in turn, have worked to help their clients achieve success in revenue cycle compliance. Broadcast segments will also include these instantly recognizable features: • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. • Legislative Update: Cate Brantley, legislative affairs analyst for Zelis, will report on current healthcare legislation.

  8. 15 Jun

    Who will Blink First? 340B Health at Center Stage as Controversy Continues

    Maureen Testoni, the stalwart president and CEO of the renowned 340B Health Program, will join the long-running Monitor Mondays to discuss Eli Lilly’s escalating demands for hospitals to submit in-house claims data as a condition of receiving 340B drug discounts.  Who will blink first? Register now to reserve your participation. Broadcast segments will also include these instantly recognizable features: ·      Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.  ·      The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.  ·      Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment. ·      Legislative Update: Folana Houston, legislative affairs analyst for Zelis, will report on current healthcare legislation.

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About

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://racmonitor.medlearn.com/racmonitor/podcasts/

Information

  • Creator
    RACmonitor
  • Years Active
    2018 - 2026
  • Episodes
    411
  • Rating
    Clean
  • Copyright
    © 2026 Monitor Mondays
  • Show Website
    Monitor Mondays

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