Monday, June 12, 2017
10-10:30 a.m. ET; 7-7:30 a.m. PT
SPECIAL GUEST
Mary A. Inman, Esq.
Constantine Cannon, LLP, San Francisco
ALSO FEATURING
Duane Abbey, PhD, CFP; Janelle Ali-Dinar, PhD;
Nancy Beckley, MS, MBA, CHC; David Glaser, Esq.;
Ronald Hirsch, MD, FACP, CHCQM; and Edward Roche, PhD, JD
A major lawsuit against a Medicare Advantage Organization (MAO) was reported last week by RACmonitor, when the U.S. Department of Justice announced a $32.5 million settlement with Freedom Health Inc. and Optimum Healthcare, MAOs based in Tampa, Fla.
The reported settlement resolves allegations that the insurers violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans. The whistleblower complaint alleged that Freedom and Optimum gamed risk-adjustment frameworks used by the Centers for Medicare & Medicaid Services (CMS) to make extra payments to MAOs for sicker patients or patients with multiple chronic conditions. Reporting this major story will be Monitor Mondays’ special guest Mary Inman, partner in the whistleblower practice group at Constantine Cannon, LLP in its San Francisco office and one of the lead attorneys representing the whistleblower in this case.
The broadcast rundown also includes:
Register now for this news broadcast coming your way on Monday, June 12, 2017 at 10 a.m. ET.
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That’s how Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz announced the publication of the CMS Final Rule on the Adoption of Standards
We’ve spent the better part of the last decade talking about what artificial intelligence (AI) can do for patients – predicting sepsis, flagging deterioration, and
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Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
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Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
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