Understanding the Compliance Issues of Reverse False Claims
The issue is reimbursement for overpayments made by the government. Today I’m writing about an unusual situation that Ronald Hirsch, MD raised recently. As a
The issue is reimbursement for overpayments made by the government. Today I’m writing about an unusual situation that Ronald Hirsch, MD raised recently. As a
During the last several months, the federal government has been siding with healthcare providers in an all-out assault on the prior authorization process, which requires
The price applicability is set to kick in for 2026. Calling it a “historic” announcement, federal officials this week introduced guidance for the Medicare Drug
The future of telehealth does, in fact, appear to be murky. Is telehealth experiencing a post-COVID-19 hangover? That’s how one healthcare executive recently labeled the
COVID exceptions to end May 11. On Jan. 30, the Biden Administration announced its intent to end the national emergency and public health emergency (PHE)
The funding comes with a particular focus on the provision of mental health services. Amid rising concerns over mental health issues affecting juveniles, federal officials
The Act has been subject of two court challenges. Most of the law’s provisions took effect at the beginning of 2022, applying to those enrolled in commercial health insurance coverage or group health plans renewing on or after Jan. 1, 2022.
It’s a really tough time for hospitals, and every dollar counts. Yet what if I told you that most voluntary funds are one-third larger than necessary?
Multiple studies have illustrated concerns regarding private equity and investment trusts purchasing and managing such facilities.
Lawsuits, congressional attention, and recent reports are all focused on the same unifying topic. This probably comes as no surprise to read, but during the
Even self-proclaimed “experts” don’t always deliver reliable information about a thorny piece of federal legislation. Over the last month I have taken in two presentations
A landmark Supreme Court decision is a game-changer in this area. After my last segment on Monitor Mondays, several colleagues contacted me about a comment

Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.

In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.

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.

Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. 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.

Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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