Compliance Conversations by Healthicity - podcast cover

Compliance Conversations by Healthicity

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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Episodes

Healthcare Marketing in a Privacy-First World

Aaron Burnett , CEO of Wheelhouse Digital Marketing Group, joins CJ Wolf to decode the complex world of healthcare marketing, privacy laws, and risk mitigation. What You’ll Learn: The evolving legal landscape: OCR guidance , AHA lawsuits, FTC enforcement Why third-party tracking is out—and what to use instead How to collaborate across marketing, IT, and compliance What “data destiny” really means for covered entities Emerging solutions like media mix modeling and private analytics Who Should Lis...

Jun 19, 202531 minEp. 116

Top Takeaways from New Skilled Nursing Facility Guidance

Join Healthicity’s CJ Wolf and Compliagent’s Paige Pennington as they break down the first industry-specific compliance program guidance (ICPG) from the OIG—focused entirely on skilled nursing facilities. Key Takeaways: Why the OIG prioritized SNFs Top risk areas flagged in the new guidance The evolving role of compliance in quality and contracting Actionable steps for aligning your risk assessments and audit plans This episode is a must-listen for compliance professionals navigating the post-ac...

Jun 05, 202547 minEp. 115

Cybersecurity in Healthcare: What Every Compliance Officer Needs to Know

In this episode of Compliance Conversations, Anurag Lal , CEO of NetSfere and former U.S. broadband official, explains why healthcare remains the top target for cybercriminals—and what you can do about it. What You’ll Learn: The evolving tactics behind healthcare cyberattacks How to identify insecure communication practices within your org What true end-to-end encryption really means Why patient care and cybersecurity are more connected than you think Tune in now and learn how to protect your or...

May 22, 202529 minEp. 114

Conferences, Coding, and Compliance: What We Learned

From artificial intelligence in audit workflows to CMS’s renewed focus on fraud, waste, and abuse, this episode of Compliance Conversations covers the biggest themes that emerged from HEALTHCON and HCCA’s Compliance Institute. Tune in to hear real takeaways from the exhibit hall, speaker sessions, and side conversations—including why quality of care oversight is gaining new attention. CJ Wolf, MD, and Brian Burton, Healthicity Chief Compliance & Privacy Officer, discuss: - Why AI was everywh...

May 08, 202539 min

What to Do When the Audit Letter Arrives

Audits are an inevitable part of healthcare. But they don’t have to throw your practice into chaos. In this episode, CJ Wolf talks with regulatory and transactional healthcare attorney Christina Kuta, a Shareholder at Roetzel & Andress, about the essential steps providers should take when facing a third-party audit. You’ll learn: - The first three things to do when you receive an audit notice - How government and commercial audits differ - Why self-auditing matters—and how to do it right - T...

Apr 24, 202531 min

Inside IROs: What Compliance Professionals Need to Know

Independent Review Organizations (IROs) play a crucial role in healthcare compliance, particularly when organizations are under a Corporate Integrity Agreement (CIA). In this episode of Compliance Conversations, CJ Wolf interviews Stephani Scott, VP of Audit Services at AAPC, on what it really means to be an IRO. You’ll discover: - What IROs do and why independence matters - The key components of CIA audit timelines and expectations - How RAT-STATS ensures unbiased sampling Thank you for listeni...

Apr 10, 202528 min

From Templates to Time-Savers: EHR Tips for Coders and Clinicians

In this episode of Compliance Conversations, host CJ Wolf chats with Elizabeth Herbert, an Epic Application Analyst with over 25 years of healthcare experience. Together, they break down the myths around EHR templates, offer practical tips for providers and compliance professionals, and explore underused tools that can streamline your day-to-day work. From proper template design to avoiding compliance risks and improving provider training, this conversation is a must-listen for anyone working in...

Mar 27, 202531 min

Stay Compliant, Stay Connected: Navigating Healthcare Outreach

In this episode of Compliance Conversations, CJ Wolf and Dan Fox explore the intersection of AI and healthcare compliance. From proactive patient outreach to regulatory risks, they break down how organizations can leverage AI while staying compliant. What You'll Learn: - How AI-driven communication is enhancing patient engagement - The biggest compliance challenges organizations face - Practical examples of AI implementation in healthcare Don’t miss this deep dive into AI, compliance, and the fu...

Mar 13, 202531 min

Top Enforcement Trends Every Healthcare Compliance Officer Should Watch

In this episode of Compliance Conversations, host CJ Wolfsits down with returning guest Sean McKenna, a Partner at Nelson Mullins and former Federal Prosecutor, to explore the critical issues at the intersection of healthcare law and compliance. From the challenges posed by the False Claims Act to the innovative use of data analytics in enforcement, Sean offers firsthand insights drawn from years of legal practice. Whether you’re managing a compliance program or navigating regulatory challenges,...

Feb 27, 202534 min

Telehealth Fraud, AI, and Cybersecurity: The Compliance Landscape in 2025

Telehealth is revolutionizing healthcare, but with new opportunities come new risks. In this latest episode of Compliance Conversations, host CJ Wolf welcomes healthcare attorney Susan Walberg to discuss: - Common telehealth fraud schemes—and how to spot them - Compliance pitfalls that could cost your organization - The latest regulatory updates from the FTC, FDA, and HHS - The role of AI in healthcare risk management - Stay ahead of compliance risks and protect your practice. Thank you for list...

Feb 13, 202536 min

What DOJ and FDA Are Looking For in Compliance Programs

Join CJ Wolf as he sits down with Clint Narver, a former DOJ prosecutor and healthcare compliance expert, to explore best practices, emerging trends, and real-world strategies for avoiding legal pitfalls. Highlights: - Learn how to safeguard your organization against research fraud. - Insights into the DOJ’s perspective on compliance programs. - Real-life examples of compliance missteps and how to avoid them. - The role of training, monitoring, and proactive measures in compliance success. Ready...

Jan 30, 202539 min

Beyond the Deal: Compliance Lessons for Healthcare Transactions

Selling or acquiring a healthcare practice is no small feat. Regulatory compliance challenges, from Stark Law violations to billing audits, can derail even the best-planned transactions. In this insightful episode of Compliance Conversations, CJ Wolf interviews Ericka Adler, a leading healthcare attorney and Shareholder at Roetzel & Andress, to uncover: - The most common compliance pitfalls in healthcare transactions - Strategies for preparing your practice for sale to ensure a smoother proc...

Jan 16, 202533 min

The Next Big Shift: AI in Healthcare Compliance and Coding

Join us for an eye-opening conversation on Compliance Conversations, where CJ Wolf interviews Nick Sahar, founder of Semantic Health and pioneer in AI for medical coding. In this episode, you’ll learn: - How AI enhances coding accuracy and speeds up workflows. - Practical use cases for AI in coding, auditing, and clinical documentation. - What the future holds for AI in healthcare compliance. Don’t miss this must-listen discussion about how technology is shaping the future of healthcare complian...

Dec 19, 202428 min

Inside Payment Integrity: Key Insights from a Payer’s Lens

In this episode of Compliance Conversations, CJ Wolf welcomes Dave Cardelle to discuss the payer perspective on payment integrity. From the complexities of DRG claims to the use of AI, this conversation sheds light on how automation and collaboration can transform the healthcare landscape. What you’ll gain: - A deep dive into DRG audits and common pitfalls. - The role of technology in reducing abrasion between payers and providers. - Real-world solutions to improve payment accuracy and efficienc...

Dec 05, 202433 min

Lessons on Compliance Communication and Leadership

In the latest episode of Compliance Conversations, CJ Wolf welcomes Jay Anstine back to explore the nuances of effective compliance communication. What You’ll Learn: - Strategies for delivering tough news to leadership - How to avoid creating a culture of false urgency - Practical tips for navigating compliance politics - The importance of clear communication plans Jay draws on years of healthcare compliance experience and shares lessons from his book, Navigating the Politics of Healthcare. Whet...

Nov 21, 202434 min

Improper Payments Explained: Tips from the Field

We’re excited to share a new episode of Compliance Conversations where CJ Wolf, MD talks with healthcare compliance expert Nancy Clark, the Senior Manager of Health Care Services at EisnerAmper! In this episode, Nancy brings decades of experience in coding and revenue management to address improper payments—a costly issue for healthcare providers. Listen in as we dive deep into: - The most common coding errors and how to avoid them - How to leverage Medicare’s transparent data to stay compliant ...

Nov 07, 202433 min

Behind the Mic: 100 Episodes of Compliance and Auditing Insights

We’re thrilled to announce a major milestone for Compliance Conversations – our 100th episode! Over the years, we’ve had the privilege of hosting industry experts to hear their invaluable perspective on best practices, trends, and real-world scenarios in compliance and auditing. This special episode is a celebration of our journey and the incredible community that’s made it possible! Join CJ Wolf, MD, Debi Behunin (Healthicity Vice President of Product), Brian Burton (Healthicity Chief Complianc...

Oct 24, 202448 min

Expert Insights on E/M Coding

In this episode, CJ Wolf, MD, and E/M coding expert Sharisa Freeman discuss her journey and insights into mastering the complexities of E/M coding. Here's a quick look at what you can expect from this episode: - The Evolution of E/M Coding: Changes in guidelines that shifted the focus to Medical Decision Making. - Medical Decision Making Tips: Understanding the three essential sub-elements: number of problems, data reviewed, and risk. - Documentation Challenges: Common issues with lower-level vi...

Oct 10, 202429 min

Healthcare Fraud, Compliance, and Expert Testimony

Ever wondered what it’s like to testify as an expert witness? We talk about that and more in this episode of Compliance Conversations! We invited compliance expert Rebecca Busch to explore her incredible journey from trauma nurse to legal expert in healthcare fraud and compliance. Join us as Rebecca shares: - Her transition from nursing to healthcare fraud examination - The key legal challenges in compliance she’s faced as an expert witness - Practical advice on how to stay ahead of compliance t...

Sep 26, 202431 min

Innovation at the Intersection of Healthcare, Science, and Startups

Tune in to this episode of "Compliance Conversations" where we dive deep into the world of innovation and biotech with our special guest, Steve VanNurden! In this episode, CJ Wolf, MD, talks with Steve VanNurden, CEO of Fitzsimons Innovation Community and Associate Vice Chancellor of Biotechnology at the University of Colorado Anschutz Medical Campus. Listen in as they explore the unique integration of academic and entrepreneurial ecosystems, discuss the reinvention of tech transfer, and reveal ...

Sep 12, 202424 min

Behavioral Health Compliance: Insights and Challenges

In this episode, Maeve O'Neill, MEd, LPC-S, CHC, CDTLF, the National Compliance Director for Circa Behavioral Healthcare Solutions, joins us to share insights from her three decades of experience in mental health and addiction services as she provides valuable insights into the unique challenges and best practices for compliance in this field. Tune in as we discuss: - The complex web of regulations: The intricate layers of compliance in behavioral health, from state regulations to accreditation ...

Aug 29, 202426 min

Navigating Medicare Audits and Appeals

Medicare audits can be a daunting challenge for any healthcare provider. With a maze of regulations, different types of audits, and a complex appeal process, it’s easy to feel overwhelmed. That’s why we invited Alicia Shickle, AHFI, CHC, CPC, CPCO, CPMA, CRC, the President and CEO of ProCode Compliance Solutions LLC, to share the knowledge and strategies you need to navigate this tricky terrain. Tune in to the episode as we discuss: - The top issues that trigger Medicare audits - How to prepare ...

Aug 15, 202435 min

Pharmacy in the Digital Age: Challenges and Innovations

Heidi McKinnon, PharmD, CHC, a seasoned compliance expert, shares insights from her journey from retail pharmacy to head of compliance at Capital Rx, a leading pharmacy benefit manager. In this episode, Heidi shares her unique path and extensive experience in the compliance world. We delve into the evolving landscape of digital pharmacy, discussing: - The true meaning of digital pharmacy and how it differs from telepharmacy and online pharmacies. - The regulatory challenges faced by digital phar...

Aug 01, 202428 min

Healthcare's Legal Tightrope: Navigating Physician Contracts

In this episode, we welcome back Hal McCard, Counsel at Spencer Fane, to delve into the complexities of financial relationships with physicians, including essential insights on compliance with STARK and Anti-Kickback statutes. CJ Wolf, MD, and Hal McCard discuss: - Hal’s extensive career in healthcare law and his journey to becoming a leading expert in the field. - Detailed explanations of STARK and Anti-Kickback statutes and their implications for healthcare organizations. - Practical advice on...

Jul 18, 202432 min

Telehealth Beyond Borders: Legalities and Logistics

Are you intrigued by the rapid evolution of telehealth and its impact across the globe? Then you won’t want to miss our latest podcast episode where Keisha Wilson and CJ Wolf discusses the nuances, challenges, and opportunities in international telehealth services! In this episode, we discuss: COVID-19’s Impact on Telehealth: Learn how the pandemic prompted a reevaluation of international telehealth practices and regulations. Compliance and Legalities: Keisha dives into the intricate details of ...

Jul 03, 202437 min

Expert Tips on Gastrointestinal Coding and Billing

In this episode, our host CJ Wolf sits down with Laidy Diana Martinez, a coding supervisor, to discuss the world of GI coding and compliance. Episode Highlights: - Introduction to GI Coding Challenges: Understand the common hurdles and how to overcome them. - Screening vs. Diagnostic Colonoscopies: Learn the critical differences and their coding implications. - Essential Modifiers: Find out which modifiers to use and when. - Documentation Best Practices: Discover what’s needed for accurate and c...

Jun 20, 202427 min

Meet Healthicity's Inaugural Compliance Officer of the Year Award Recipient

Our latest episode of Compliance Conversations features Johanna Brown, the recipient of Healthicity's 2023 Compliance Officer of the Year Award! Join our host, CJ Wolf, as he delves into Johanna’s journey in compliance, her leadership philosophy, and the qualities that make her an outstanding compliance officer. Here’s what you can expect: - Career Journey: Learn about Johanna’s path from journalism to compliance. - Leadership Insights: Discover her secrets to fostering teamwork, maintaining wor...

Jun 06, 202427 min

Demystifying Anesthesia Coding and Billing

We’re excited to announce a new episode of Compliance Conversations! Join CJ Wolf and special guest Kimberly Jolivette Williams as they explore the complexities of anesthesia coding and billing. In this episode: - Kimberly’s journey from unit secretary to compliance expert. - Unique aspects of anesthesia coding and essential resources. - The importance of modifiers in compliance and billing. - Tips for accurate documentation and minimizing compliance risks. Don't miss out on Kimberly's expert ad...

May 23, 202432 min

Insider Insights: HCCA & HEALTHCON Recap

Our latest episode of Compliance Conversations features CJ Wolf, MD, and Brian Burton, our Chief Compliance and Privacy Officer, sharing their key takeaways from two of the most prominent industry conferences: HCCA's Compliance Institute and AAPC's HEALTHCON. Find out what they had to say about insights on the OIG’s new General Compliance Program Guidance, industry-specific updates, and so much more. From discussions on artificial intelligence in compliance to the latest developments in Medicare...

May 09, 202431 min

Critical Care Anywhere: Exploring Tele-ICU's Impact

We're thrilled to share the latest episode of Compliance Conversations featuring a Jeni Colarusso, a seasoned nurse and an expert in telehealth and Tele-ICU systems. In this episode, Jeni dives deep into the transformative power of telehealth, particularly in critical care environments. Episode Highlights: - Jeni’s extensive experience in surgical and cardiac ICU settings. - An in-depth look at Tele-ICU and its role in expanding access to specialist care in remote areas. - The impact of technolo...

Apr 25, 202428 min
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