Compliance Conversations by Healthicity

Telehealth remains one of the most dynamic and closely watched areas in healthcare compliance. In this episode of Compliance Conversations, CJ Wolf welcomes back telehealth compliance expert Keisha Wilson, founder of KW Advanced Consulting, for a timely discussion on the latest telehealth developments, including newly extended flexibilities, evolving documentation requirements, and the audit risks organizations cannot afford to ignore. With key telehealth provisions now extended through December 31, 2027, many providers may feel a sense of relief. But as Keisha explains, the extension of flexibilities does not eliminate the complexity. In many ways, it raises the stakes for compliance teams, coders, administrators, and revenue cycle leaders who need to ensure their organizations are using telehealth appropriately, documenting correctly, and staying aligned with changing payer and regulatory expectations. During the conversation, CJ and Keisha break down what the latest legislative changes mean in practical terms, including the continued use of the patient’s home for telehealth services, ongoing allowances for audio-only services in certain situations, and continued telehealth participation for FQHCs, RHCs, physical therapists, occupational therapists, speech-language pathologists, and audiologists. They also discuss where organizations may be most vulnerable, including: Keisha also shares practical recommendations for staying current, including which websites and resources compliance leaders should monitor as telehealth rules continue to evolve across Medicare, Medicaid, commercial payers, and state laws. If your organization provides telehealth services, this episode offers a valuable look at the operational and compliance details that deserve closer attention in 2026. Episode Resources: KW Advanced Consulting: https://kwadvancedconsulting.com/telehealth-in-2026-and-beyond-what-the-latest-extensions-mean-for-healthcare/Center for Connected Health Policy (CCHP): https://www.cchpca.org/American Telemedicine Association (ATA): https://www.americantelemed.org/ 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

Medical decision making shouldn’t feel like a coding puzzle, and your documentation shouldn’t read like a template checklist. In this episode, CJ Wolf is joined by Amanda Reikowsky, a coding quality audit & education supervisor at Hackensack Meridian Health and founder of CodeWise Solutions, LLC, to break down what MDM documentation should look like today—and why the best notes focus on the story and rationale behind care. What you’ll learn Why this matters Over-documentation and cloned notes don’t just create compliance risk—they make it harder for clinicians to find what’s relevant, and harder for coders and auditors to validate the level of service. Clear clinical reasoning protects patient care, supports accurate coding, and strengthens defensibility. Reach out to Amanda at codewisemedical@gmail.com or visit her website at www.codewisesolutionsllc.com. 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

Mentorship can be the difference between feeling stuck and building a career with real direction. In this episode of Compliance Conversations, CJ Wolf is joined by Barbara Shaw, a seasoned healthcare coding, auditing, and risk adjustment professional who has made mentoring new coders a meaningful part of her work, especially through her involvement as an AAPC local chapter officer. Barbara shares why mentorship is so rewarding, how she structures mentoring relationships in a realistic way, and what she’s learned about helping people move from “interested” to “ready.” What you’ll learn How mentorship actually worksWhere to find supportChoosing your next stepRemote work expectationsSustaining professional growthAbout Barbara Shaw Barbara Shaw brings decades of hands-on experience across coding, auditing, and population health. She spent 20 years working in OB/GYN practices and later went on to build and lead a risk adjustment auditing team. During her time at Duke University, she used Healthicity to support audit workflows, with a focus on OB/GYN, emergency department, and risk adjustment audits. Her career has also included work with several Medicare Advantage payers and ACOs. Today, she is part of the team at Mass General Brigham, where she is happy to be back in Population Health, focusing on outpatient CDI. Barbara is a strong supporter of AAPC and is actively involved at the chapter level. She frequently speaks at local chapter meetings and currently serves her local chapter as the education officer, helping support and mentor the next generation of coding 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: revertedbehavioral healthABNspayer & state policiesfront desk workflowWho 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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:Backlogs & timing:Medicare Advantage focus:Telehealth decisions: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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:Real-world whistleblowing:Anti-retaliation basics:Stronger programs:Guests Jacklyn DeMarElin KunzResources 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

Artificial intelligence is no longer a future concept; it’s here, embedded in healthcare systems, vendor platforms, and even your day-to-day operations. But with innovation comes risk. In this episode of Compliance Conversations, host CJ Wolf, MD, talks with Santosh Kaveti, Founder and CEO of ProArch, about: Emerging AI Risks:Governance & Education:Explainability:Future-Proofing:Get actionable insights to help you stay ahead of regulation, strengthen data security, and keep patient safety at the center of your strategy. 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

Artificial intelligence is transforming healthcare, from ambient documentation to virtual assistants. But as opportunities grow, so do risks. How can compliance and security leaders enable innovation while ensuring patient safety and regulatory alignment? In this episode of Compliance Conversations, CJ Wolf talks with Walter Haydock, former national security advisor and founder of StackAware. Together they unpack: Resources: You can find additional resources from Walter Haydock below: Free in-person risk assessment for healthcare CxOsFree email course on ISO 42001How to deploy high-risk artificial intelligence systems and still comply with Colorado SB-205 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

In this episode of Compliance Conversations, CJ Wolf sits down with Melinda Hawk, recognized as Healthicity’s Revenue Cycle Manager of the Year, to talk about her career journey, leadership lessons, and the power of collaboration between compliance and revenue cycle teams. What You’ll Learn: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

In this episode of Compliance Conversations, CJ Wolf speaks with Eddie Qureshi, CEO of Rainfall Health, to break down the new CMS TEAM Model—and what it means for your hospital’s future. What You’ll Learn: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

In this episode of Compliance Conversations, CJ Wolf, MD, is joined by Rui Ribeiro, Co-Founder and CEO of Jscrambler, to dive into the client-side security threats healthcare organizations often overlook. From patient portals to embedded video players, Rui explains how browser-based vulnerabilities are creating new risks that healthcare teams need to be aware of. You’ll learn: 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

In this powerful episode of Compliance Conversations, CJ Wolf interviews Dave Cardelle, RPh, Chief Strategy Officer at AMS, who shares practical insights on CMS’s shifting enforcement landscape and the real-world impact of hospital price transparency. What You’ll Learn: You can also listen to Dave’s previous Compliance Conversations interview on payment integrity considerations from a payer’s perspective. 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

In this episode of Compliance Conversations, CJ Wolf welcomes back Maya Turner, a nationally recognized expert in medical coding and consulting. Together, they explore how value-based care and ancillary services are transforming provider reimbursement, especially in a telehealth-enabled world. You'll learn: Whether you're already billing for chronic care or just starting to explore value-based models, this episode will help you uncover new revenue opportunities—without adding more hours to your day. 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: OCR guidanceAHA lawsuits,FTC enforcementWho Should Listen: Compliance officers, healthcare marketers, IT leaders, and anyone responsible for HIPAA risk management in a digital world. 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.

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: This episode is a must-listen for compliance professionals navigating the post-acute space. You can reach out to Paige at ppennington@compliagent.com or via phone at 310-736-4972. 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. LinkedInYoutubeFacebookInstagram Check out our resource center and weekly compliance newsletter for additional compliance and auditing content from our experts.