In a landmark episode of 1st Talk Compliance, Kevin Chmura, CEO of Panacea Healthcare Solutions and host of the show, is joined by George Kelley, president of Panacea’s KA Consulting Services division. For over 40 years, KA Consulting Services has delivered unmatched revenue cycle solutions, helping hospitals and health systems nationwide enhance reimbursement, improve compliance, and streamline Medicaid eligibility. Known for its eligibility services, clinical coding and auditing...

The False Claims Act—alongside the Anti-Kickback Statute and Stark Law—represents one of the five core fraud, waste, and abuse laws identified by the HHS Office of the Inspector General. Out of the billions of dollars reclaimed through False Claims Act recoveries in 2023, the majority was attributed to the healthcare industry. This concerning trend highlights the importance of maintaining robust compliance programs and prioritizing education surrounding these regulations. In this episode...

Previously on First Talk Compliance, we spoke with Kevin Chmura, CEO of Panacea Healthcare Solutions, about how the advent of price transparency has caused the business of healthcare to evolve and opened up fresh possibilities for healthcare providers to gain a competitive advantage. In this episode, we continue that conversation by inviting on two additional experts from Panacea—Govind Goyal, President of Financial Services, and Henry Gutierrez, Senior Vice President, Financial Consulting...

Private equity has become increasingly entrenched in the healthcare sector, offering various financing options for providers to consider. However, like all types of financing, private equity introduces its own unique set of benefits and drawbacks and carries important legal implications. It’s essential to understand all the factors at play in order to maximize financial impact and preserve operational efficiencies while avoiding sacrificing compliance and quality of care. Tune in to hear...

Grace Walsh speaks with Kevin Chmura, CEO at Panacea Healthcare Solutions, to explore an extremely timely topic: price transparency and its far-reaching impact on how healthcare providers interact with consumers, with each other, and with the market at large. Tune in as Kevin shares some important insights about how price transparency has opened the door to a whole new world of data analysis and strategic business strategies for healthcare providers, and covers what we might expect to see for...

Grace Walsh is joined by Govi Goyal, President of Panacea's Financial Services Division, and Brian Prokop, Senior Vice President of Financial Consulting Services at Panacea, to discuss the importance of undertaking a strategic pricing initiative for your organization. In our current healthcare climate, it's more crucial than ever to maintain defensible and rational healthcare pricing while remaining competitive and optimizing net revenue. As Govi and Brian can tell you, it's a tricky balance...

Grace Walsh is joined by Becky Jacobsen, Vice President of CDM, Coding & Audit Services at Panacea Healthcare Solutions, to explore the key updates to evaluation and management (E/M) guidelines for 2024. On the surface, this year's changes may appear fairly straightforward, but dig a little deeper and you’ll find that the updates have important implications for correct coding procedures. From payers, providers, and coders to those who work in auditing or IT template development, it is...

Grace Walsh is joined by Becky Jacobsen, Vice President of CDM, Coding & Audit Services at Panacea Healthcare Solutions, to explore the key updates to evaluation and management (E/M) guidelines for 2024. On the surface, this year's changes may appear fairly straightforward, but dig a little deeper and you’ll find that the updates have important implications for correct coding procedures. From payers, providers, and coders to those who work in auditing or IT template development, it is...

In this episode of 1st Talk Compliance, we dive into an increasingly crucial topic in healthcare: price transparency and its ever-growing impact on the industry. Kevin Chmura, CEO at Panacea Healthcare Solutions, joins us to share expert insights on strategic pricing and compliance, emphasizing the transformative benefits for healthcare providers. Learn how to proactively engage with CMS regulations and set your organization apart as an ethical leader in the realm of price transparency.

Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX will be presenting this informative webinar. Cybersecurity risk management and the potential for enforcement actions is not diminishing. An area of increasing interest by the Federal Trade Commission, the United States Department of Justice, and Congress is third parties taking sensitive data (especially by social media and search engine giants), including protected health information, without...

1st Talk Compliance features guest Govi Goyal, President, Financial Services, at Panacea Healthcare Solutions, on the topic of Evolution of Price Transparency and How to Stay Ahead of CMS Requirements. Govi joins our host Catherine Short to discuss how the new CMS Price Transparency Rule and No Surprises Act are closely related. By providing Good Faith Estimates for healthcare services, hospitals can comply with both regulations. This helps patients understand their expected costs upfront and...

1st Talk Compliance features attorneys Sean McKenna, Lauren Nelson, and Vincent Aiello of Spencer Fane LLP, on the topic of Healthcare Assets: How to Preserve and Protect. We will discuss the interplay between enforcement and liability proceedings with asset protection, explore how government and private litigation matters can impact healthcare companies, clinicians, and executives, and provide tips and preventative strategies to preserve income and assets prior to such action to ensure...

1st Talk Compliance features guest Lauren Moak Russell, Counsel at Young Conaway Stargatt & Taylor, LLP in Wilmington, Delaware, on the topic of “A Harassment-Free Workplace vs the Right to Engage in Concerted Activity.” Lauren joins our host Catherine Short to discuss how the National Labor Relations Board under the Biden Administration has expressed a renewed interest in expanding its influence into non-unionized work forces. This includes reviewing and--in the right circumstances...

Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us through current trends and tips. With its roots stemming back to 1863, the False Claims Act continues to be the U.S. Department of Justice's primary enforcement tool for returning money to the Federal Treasury. It is also considered one of five fundamental fraud, waste, and abuse laws, which potentially impact a provider every time a claim is submitted to Medicare,...

1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of A Practical Approach to The Safe Harbor Law. Ray joins our host Catherine Short to discuss how HIPAA data breach penalties typically get measured in millions of dollars, even following an organization implementing NIST cybersecurity framework measures. However, with the new HIPAA Safe Harbor Law, signed in January 2021, HHS and OCR may consider some penalty mitigation. It is important to...

Raymond Ribble is the CEO and Founder at SPHER, Inc. HIPAA data breach penalties typically get measured in millions of dollars even following an organization implementing NIST cybersecurity framework measures. It is important to understand that the Safe Harbor Law, while offering substantial protection, does not provide a true safe harbor. Our presentation will examine what are the established security practices for healthcare, and how to pivot your organization's security profile in order to...

1st Talk Compliance features guest Iliana L. Peters, Shareholder at Polsinelli PC, on the topic of The Risk of Data Sharing. Iliana joins our host Catherine Short to discuss how these days, health data is an incredibly valuable commodity. Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. In this episode, we will be discussing the scope and breadth of data sharing projects in development in the health care sector, examine...

1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., on the topic “DMEPOS – In Compliance with CMS.” Rachel joins our host Catherine Short to discuss special payment rules associated with durable medical equipment, prosthetics, orthotics and supplies. DMEPOS products must meet quality standards, suppliers need to be accepted by Medicare to participate, similar to providers, and are subject to fraud, waste, and abuse laws. This...

An audio version from the live event: It’s important to understand how the application of the 2023 E&M codes impacts reimbursement. Inaccurate coding and inefficient documentation practices can result in a decline in revenue and increase the likelihood of downstream inaccuracies of patient data. Join Panacea Healthcare Solutions’ Director of Coding & Documentation Services, Becky Jacobsen, CCS-P, CPC, CPEDC, CBCS, MBS, CEMC, BSN, and Executive Vice President of Coding &...

Expert presenter, Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX guides us during this important and informative webinar. Breaches and the lack of the requisite technical, administrative, and physical safeguards can have criminal consequences. While most people are familiar with civil cases, there is the potential for HIPAA violations and ransomware attacks to be prosecuted criminally. The purpose of this webinar is to highlight potential areas...

1st Talk Compliance features guest Raymond Ribble, CEO and Founder at SPHER, Inc., on the topic of “Employee Snooping & Insider Threats.” Ray joins our host Catherine Short to discuss snooping and insider threats and why user monitoring and ePHI access strategies are vital to the security of sensitive patient information and data protection. With so much attention and money surrounding cybersecurity in the healthcare industry, malicious employees may decide to purposefully disclose...

Iliana L. Peters, Shareholder at Polsinelli PC will be leading this engaging audio version of her webinar presentation. These days, data is more valuable than oil. And health data is the most valuable of all data! Companies of all types should consider the legal risk with data valuation, data ownership, and data sharing agreements. Data sharing projects take many forms and address many important issues, including improvements in patient safety, fraud and abuse, population health, research,...

1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “A Business Associate Agreement? Tell Me More!” Rachel joins our host Catherine Short to discuss how Business Associate Agreements (BAA) are not new; however, some individuals are new to healthcare and others never understood what a BAA is exactly. A BAA is a contract that fundamentally gives assurances that the parties are complying with the...

1st Talk Compliance features guest Trey Scott, Coordinating Attorney at Kennedy, Attorneys & Counselors at Law, on the topic of “Have a Breach? Reporting Requirements with the OCR.”Trey joins our host, Catherine Short to discuss the reporting requirements for a data breach of a healthcare provider, the definition of a breach, different timelines for reporting breaches, as well as how to complete a breach reporting form from the Office of Civil Rights.