Compliance Conversations by Healthicity

CJ Wolf
  • 4.8 (17)
  • EDUCATION
  • UPDATED MONTHLY

Compliance Conversations is a biweekly podcast for healthcare professionals and compliance officers who want to stay on top of the compliance game. Host CJ Wolf has in-depth conversations with industry experts to explore the riddles and complexities of the compliance world. Wolf chats with fellow compliance experts, auditors, physicians and government officials. Compliance Conversations is produced by Healthicity.

  1. JAN 29

    Physician Buy-In, Audit Blind Spots, and Enforcement Trends

    Compliance risks don’t always start in obvious places—and that’s what makes them dangerous.  In this episode of Compliance Conversations, host CJ Wolf talks with Amy Bailey of HBE Advisors about the real-world compliance failures she sees most often across hospitals and physician groups nationwide. Drawing on decades of experience with investigations, self-disclosures, and Corporate Integrity Agreements, Amy shares practical insights compliance leaders can apply immediately.  In this episode, you’ll learn:  Where compliance blind spots commonly occur—and why frontline teams matter How missed or misunderstood payer correspondence can escalate into enforcement actions What works (and what doesn’t) when gaining physician buy-in Why traditional audit approaches miss documentation and behavior risks Key enforcement and audit trends shaping compliance priorities today Whether you’re managing audits, responding to payer inquiries, or building a proactive compliance strategy, this episode delivers candid insights you won’t find in a policy manual.  You can also see Amy at the upcoming HCCA 30th Annual Compliance Institute where she’ll be presenting  “Bridging Boundaries: Strengthening Collaboration Between Healthcare Organizations, Independent Review Organizations, and OIG Monitors.”  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    33 min

  2. JAN 15

    Doing the Right Thing the Wrong Way: Refunds in Healthcare Compliance

    Refunds and overpayments sit at the intersection of compliance, finance, and legal risk. In this episode of Compliance Conversations, CJ Wolf speaks with David Glaser, healthcare attorney and in Fredrikson’s Health Law group, about how organizations can navigate refund decisions with greater confidence and clarity.  Drawing from years of advising providers nationwide, David explains:  The difference between binding law and non-binding guidance Navigating refunds How far Medicare can actually look back on claims This practical, real-world conversation is essential listening for compliance, audit, revenue integrity, and legal professionals.  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    37 min

  3. 12/18/2025

    Building Ethical Cultures That Drive Innovation

    In this episode of Compliance Conversations, host CJ Wolf sits down with Jill Fallows Macaluso, Corporate Vice President and Chief Compliance Officer at Novo Nordisk, to explore how ethical culture, psychological safety, and empowered risk-taking can transform compliance from a regulatory obligation into a strategic asset.  Jill shares insights from more than two decades in a highly regulated industry, discussing how organizations can move beyond check-the-box compliance and build cultures that foster trust, innovation, and sustainable business results.  In this episode, you’ll learn:  Why ethical culture consistently correlates with stronger business performance How psychological safety strengthens both compliance and innovation What “risk-based decision-making” really looks like in practice How leaders can empower teams without sacrificing accountability Why inclusion is foundational to ethical, high-performing organizations Whether you’re a compliance officer, legal leader, or executive, this conversation offers practical guidance for building a culture where people feel safe to speak up, take smart risks, and do the right thing.  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    29 min

  4. 12/04/2025

    Why Case Management Is Critical to Demonstrating Compliance

    In this episode of Compliance Conversations, healthcare compliance expert Jessica Zeff, the Founder & CEO of Simply Compliance, shares real-world insight into why structured, electronic case management is essential for demonstrating compliance, managing risk, and responding efficiently to audits and investigations.  What You’ll Learn  What compliance case management actually looks like in practice Why consistency and categorization matter for risk analysis Common mistakes organizations make when handling compliance cases How case management supports audits, investigations, and leadership reporting Why even basic systems are better than none Who Should Listen  Compliance officers, privacy professionals, legal teams, audit teams, and anyone responsible for managing compliance or incident investigations.   About Jessica Zeff:  Jessica Zeff is the CEO & Founder of Simply Compliance, a healthcare compliance consulting firm specializing in regulatory compliance, privacy, and risk management. A strategic leader with nearly 25 years of experience, Jessica is skilled in building compliance programs, translating complex regulations into actionable strategies, and mitigating compliance risks through proactive program development and data-driven decision making.  Jessica is also an experienced speaker and educator, having delivered presentations and webinars for the Health Care Compliance Association (HCCA) and numerous healthcare partners on topics ranging from privacy and data security to compliance risk management. She is the creator and host of the Compliance Deconstructed podcast, where she explores practical approaches to healthcare compliance, and the author of the popular blog series Olivia’s Compliance Diaries, which brings real-world compliance lessons to life through storytelling.  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    42 min

  5. 11/20/2025

    Rethinking Critical Care Coding Beyond the Bedside

    Critical care coding isn’t just about time at the bedside. In this new episode of Compliance Conversations, CJ Wolf and Maya Turner discuss how recent CPT® guidance expands what’s billable, from telehealth consults to pre-arrival care coordination.  Key Takeaways:  When critical care starts (and where it doesn’t) CPT® vs. CMS Guidance— and what happens when they differ How to handle transport, telehealth, and overlapping E/M services Ways to help providers feel recognized — even when the answer is “no” Here is a link to the OIG audits referenced in the episode.  You can read Maya’s book, Billable: The Revenue Cycle Professional's Guide to Branding, for more insights.  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    33 min

  6. 11/06/2025

    Telehealth Compliance in Late 2025

    As federal deadlines, a shutdown, and stalled legislation churn the rules, telehealth coverage looks different across Medicare, Medicaid, and commercial payers. In this episode, CJ Wolf, MD and Keisha Wilson (Founder/CEO of KW Advanced Consulting) breaks down what’s actually covered right now—and how to stay compliant without disrupting care.  You’ll learn:  Where Medicare telehealth reverted and where behavioral health remains an exception How to use ABNs correctly (and why timing is everything) Why payer & state policies diverge—and how to operationalize a payer matrix The must-have front desk workflow: eligibility, POS, modifiers, codes HIPAA platform requirements and documentation tips Who should listen: Compliance leaders, revenue cycle teams, practice managers, telehealth program leads, behavioral health providers.  Recorded: October 30, 2025 (details current as of this date)  You can also tune into our previous Compliance Conversations episode with Keisha, The ABCs of ABNs.  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    34 min

  7. 10/23/2025

    Shutdowns, Telehealth & Enforcement: Compliance Perspectives on Current Events

    Headlines change. Your mandate doesn’t.   In this Compliance Conversations episode, CJ Wolf, MD, and Brian Burton, Healthicity Chief Compliance & Privacy Officer, cut through the noise to show how to keep programs objective, patient-first, and audit-ready—even amid shutdowns, delayed rules, and shifting priorities.  What you’ll learn  Enforcement reality check: Why fraud, waste, and abuse actions keep moving—and how to prepare. Backlogs & timing: Practical impacts of shutdowns on OCR complaints, self-disclosures, and CIAs. Medicare Advantage focus: Signals that MA audits are scaling and what that means for you. Telehealth decisions: “Hold or bill?” Cash-flow, denial risk, and documenting your rationale.  Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    33 min

  8. 10/09/2025

    Inside the Whistleblower’s World: What Compliance Needs to Know

    CJ Wolf sits down with Jacklyn DeMar (President and Chief Executive Officer of The Anti-Fraud Coalition) and Elin Kunz (testifying expert and former whistleblower) to explore the False Claims Act (FCA), the realities of retaliation, and how compliance programs move from “paper tiger” to practice.  What You’ll Learn  FCA in plain English: How cases start, why most settle, and the government’s role Real-world whistleblowing: Documenting concerns, building evidence, and choosing counsel Anti-retaliation basics: What protections exist and how to think about timing Stronger programs: Closing gaps between contracting, coding, and monitoring Guests  Jacklyn DeMar, President & CEO, Anti-Fraud Coalition Elin Kunz, coding/billing expert witness; former whistleblower Resources from The Anti-Fraud Coalition  https://www.taf.org/  https://www.taf.org/podcast/  https://www.taf.org/latest-news/   Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

    51 min
See All (131)

4.8
out of 5
17 Ratings

About

Compliance Conversations is a biweekly podcast for healthcare professionals and compliance officers who want to stay on top of the compliance game. Host CJ Wolf has in-depth conversations with industry experts to explore the riddles and complexities of the compliance world. Wolf chats with fellow compliance experts, auditors, physicians and government officials. Compliance Conversations is produced by Healthicity.

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