PYA Webinar Recast

This episode outlines the top 10 healthcare compliance risk areas managers need to know in 2026. PYA compliance leaders, Shannon Sumner, Miriam Murray, and Katie Croswell, discuss vendor oversight, cybersecurity and data breaches, artificial intelligence governance, digital transformation, healthcare real estate, EMTALA compliance, exclusion screenings, and reimbursement pressures. The session emphasizes practical risk mitigation strategies, including third-party risk management life cycles, AI inventory and governance structures, access monitoring, documentation standards, and continuous auditing. Listeners will gain a structured view of emerging and persistent compliance risks affecting healthcare organizations. 

This episode examines how healthcare organizations can mitigate compliance and financial risk while conducting revenue integrity audits. PYA Principal Valerie Rock and Manager Kimberly Campbell walk through the auditing and monitoring cycle, with a focus on defensible sampling, documentation, and interpretation of results. The discussion covers: Probe audits versus statistically valid random samples Use of data analytics Understanding claims and financial error rates Navigating the Medicare 60-day rule when overpayments are identified Corrective actions Root cause analysis Internal controls needed to support sustainable compliance after an audit

This episode reviews new proposed rules, payment models, and regulatory guidance affecting healthcare organizations in early 2026. PYA Principals Martie Ross and Kathy Reep break down recent legislative activity, Medicare and Medicaid policy updates, and regulatory changes providers should be tracking as the year begins. Topics include: Medicare telehealth extensions Healthcare extenders Medicaid work requirements Medicare Advantage oversight 340B drug program developments Price transparency rules Interoperability initiatives Emerging alternative payment models The discussion highlights how these changes may affect reimbursement, compliance, and operational planning.

This episode examines key policy, payment, and program changes shaping rural healthcare in 2026. PYA Principals Martie Ross and Kathy Reep discuss major federal initiatives affecting rural providers, including the Rural Health Transformation Program, Medicare telehealth policy, and Medicaid developments. The session also addresses Medicare Advantage oversight, 340B drug program compliance, price transparency requirements, and emerging alternative payment models. Throughout the discussion, the presenters highlight practical implications for rural hospitals and health systems as they plan for regulatory and reimbursement changes in the year ahead. Presented by Martie Ross and Kathy Reep on January 15, 2026. Key topics include: The Rural Health Transformation Program Medicare telehealth updates Medicare Advantage reforms 340B drug program requirements Hospital price transparency Evolving alternative payment models The session provides context and planning considerations for rural organizations navigating a complex regulatory environment.

This episode of PYA's Healthcare Regulatory Roundup continues a two-part discussion on the 2026 Medicare Physician Fee Schedule Final Rule, with a focus on telehealth, global payment reforms, and skin substitutes. The conversation walks through what stays in place for telehealth, including face-to-face visit requirements, and highlights new codes related to telebehavioral health and global surgery indicators. The episode also examines changes to global payment methodologies and post-operative care valuation, along with a major shift in how skin substitutes will be paid under Medicare. Additional updates include new care management codes for behavioral health integration and remote monitoring, as well as the extension of the Medicare Diabetes Prevention Program's virtual option through 2029. Presented by Valerie Rock and Martie Ross on December 10, 2025. Topics Covered: Telehealth Global Payments Skin Substitutes Care Management Prevention and Wellness

This episode of PYA's Healthcare Regulatory Roundup examines the 2026 Medicare Physician Fee Schedule Final Rule and its impact on physician reimbursement, payment calculations, and quality reporting. The discussion covers updates to the conversion factor under MACRA, budget neutrality adjustments, new efficiency adjustments affecting work RVUs, and revisions to the practice expense methodology.The presenters also review finalized changes to MIPS quality, cost, and interoperability requirements, along with the introduction of the mandatory Ambulatory Specialty Model beginning in 2027. The episode concludes with considerations for physician practices and healthcare organizations as they evaluate compliance obligations and reimbursement impacts under the final rule. Presented by Martie Ross, Sarah Bowman, and Lori Foley on December 3, 2025. Topics Covered: 2026 Payment Rate/Conversion Factor Efficiency Adjustment Practice Expense Methodology Ambulatory Specialty Model (new mandatory alternative payment model) Merit-Based Incentive Payment System (MIPS) Medicare Shared Savings Program (MSSP)

The Centers for Medicare & Medicaid Services (CMS) published the 2026 Hospital Outpatient Prospective Payment System (OPPS) final rule. In this webinar, Martie Ross and Kathy Reep discussed key provisions of the 2026 Hospital OPPS final rule and related developments. Attendees will gain knowledge from these learning objectives:  Details of 2026 OPPS final rule Developments in care for end-stage renal disease Status update on home health final rules Information about payment updates Actions on site neutrality Changes to the 340B Drug Program Aspects of the inpatient-only list Updates about price transparency This webinar is part of PYA's twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. For more than 40 years, PYA has been committed to regulatory compliance and helping healthcare organizations create attainable compliance programs while mitigating risks.  

A strong compliance program begins with a clear understanding of organizational risks. This webinar guides you through the purpose, process, and practical application of conducting a compliance risk assessment—and how to transform the findings into a robust annual framework. During this webinar, PYA Principals Shannon Sumner and Rhonda Buckholtz explained the importance of effective risk assessments and how to incorporate them into your annual plan. Shannon and Rhonda addressed the following objectives: Defining the role of risk assessments. Identifying common risk areas. Applying a structured methodology. Demonstrating documentation practices for key stakeholders. Incorporating ongoing monitoring and feedback loops to update risk assessments. RELATED LINKS: U.S. Department of Justice Criminal Division Evaluation of Corporate Compliance Programs OIG General Compliance Program Guidance COSO ERM Framework   *This recording was updated on February 11, 2026 to fix an audio issue. The edit is technical only and does not impact the content of the webinar.

On October 1 — the first day of the new federal fiscal year — PYA's Martie Ross and Kathy Reep provided a timely update on federal policy developments shaping healthcare. They reviewed the latest actions from Congress and federal agencies, focusing on issues that have a direct impact on providers and healthcare organizations. Key topics for discussion included: Federal FY 2026 discretionary spending and government shutdown risk Calendar Year 2026 Medicare sequestration status Rural Health Transformation Program funding opportunity and deadlines Congressional hearings on tax-exempt hospitals New visa application fees and implications for healthcare

The Food and Drug Administration (FDA) has issued draft guidance to establish a comprehensive regulatory framework for artificial intelligence and machine learning (AI/ML) in medical devices. As AI becomes embedded in connected health technologies, the cybersecurity risks associated with such devices are growing exponentially. This webinar explores how the FDA's lifecycle-based approach to AI regulation intersects with cybersecurity for connected medical devices. Principals Barry Mathis and John Cross provided an overview of the FDA's draft guidance on AI/ML-enabled medical devices and discussed how cybersecurity risks in the Internet of Medical Things (IoMT) can be addressed. Attendees gained knowledge through these learning objectives: Learn about AI and its use cases, including use in embedded medical devices Understand the FDA's Total Product Lifecycle approach to regulating AI/ML-enabled medical devices Identify cybersecurity risks unique to IoMT devices Analyze a real-world case study of an AI-enabled insulin pump and its cybersecurity implications Apply compliance strategies, including Secure Product Development Frameworks and Software Bill of Materials, to meet FDA expectations This webinar is part of PYA's twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. PYA is dedicated to helping healthcare organizations understand regulatory requirements and prepare for and respond to cybersecurity threats.

On July 31, the Centers for Medicare & Medicaid Services (CMS) issued both the 2026 Medicare Inpatient Prospective Payment System (PPS) and the Skilled Nursing Facility (SNF) PPS final rules. PYA's Martie Ross and Kathy Reep discussed several key provisions, including: Payment rate increases for inpatient acute facilities, long-term care hospitals, and skilled nursing facilities Revisions to the mandatory Transforming Episode Accountability Model (TEAM) Changes to the wage index and related policies Updates to the Hospital Inpatient Quality Reporting program Changes to the Hospital Readmissions and Hospital-Acquired Conditions Reduction programs, as well as the Hospital Value-Based Purchasing program Revisions to the Promoting Interoperability program Martie and Kathy also addressed key provisions in the 2026 Inpatient Rehabilitation Facility and Inpatient Psychiatric Facility final rules issued by CMS on August 1. 100th Webinar! On August 27, PYA's twice-monthly Healthcare Regulatory Roundup (HCRR) celebrated its 100th webinar in the series. Beginning with the first webinar in 2021, PYA experts have reliably provided practical insights on the latest industry regulatory developments. Thank you for your support of this sentinel series. PYA is dedicated to helping healthcare organizations understand and comply with legislative and regulatory impacts. Contact Martie, Kathy, or any of our experts for assistance.

On July 14, CMS released the 2026 Medicare Physician Fee Schedule Proposed Rule (MPFS). The proposed rule includes several significant policy changes that could impact physicians for years to come. During this two-part webinar series, PYA experts went deep into these changes to help you understand and prepare for what's coming next. Presented August 13, 2025, by Valerie Rock and Martie Ross Topics: Telehealth Global Payments Skin Substitutes Care Management Prevention and Wellness The popular twice-monthly PYA Healthcare Regulatory Roundup provides practical insights on the latest industry regulatory developments. PYA helps healthcare leaders with legislative and regulatory impacts and matters involving compliance, valuation, strategy, and transactions.

On July 14, CMS released the 2026 Medicare Physician Fee Schedule Proposed Rule (MPFS). The proposed rule includes several significant policy changes that could impact physicians for years to come. During this two-part webinar series, PYA experts will go deep into these changes to help you understand and prepare for what's coming next. Presented July 30, 2025, by Martie Ross, Sarah Bowman, and Lori Foley Topics Covered: 2026 Payment Rate/Conversion Factor Efficiency Adjustment Practice Expense Methodology Ambulatory Specialty Model (new mandatory alternative payment model) Merit-Based Incentive Payment System (MIPS) Medicare Shared Savings Program (MSSP)

Compensation is no longer just a financial tool—it's a powerful strategy to shape behavior, align priorities, and drive performance. Thoughtful compensation design can foster a culture of quality, boost collaboration and accountability, and enhance patient and provider satisfaction. During this webinar, PYA Principal Angie Caldwell and Manager Ericka Dickinson discussed why strategically aligned compensation models are so important in today's healthcare landscape and provided ways to align your provider compensation models to your organization's strategic goals. Attendees gained knowledge from these learning objectives: Learn ways your organization may be impacted by a strategically aligned compensation model Understand how to enhance recruiting efforts Gain improvement in retention and satisfaction rates Assess methods to operationalize alignment   Learn more: Benefits of strategically aligned compensation models PYA's Compensation Valuation Planning and Design For more than 40 years, PYA has helped healthcare leaders with provider compensation design, fair market value, commercial reasonableness, and other matters related to compensation valuation, compliance, strategy, and integration. Presented: July 22, 2025.

The One Big Beautiful Bill Act (OBBBA) is now law, and healthcare providers must quickly assess its implications. In this session, PYA's Martie Ross and Kathy Reep examined OBBBA's sweeping changes to Medicare, Medicaid, and the ACA Marketplace. Martie and Kathy also addressed new proposed rules from the Centers for Medicare & Medicaid Services (CMS), including the 2026 hospital outpatient, home health, and end-stage renal disease payment rules. Presented on: July 16, 2025.

Twice each year, PYA's Center for Rural Health Advancement presents a deep dive into the most challenging regulatory and reimbursement issues facing rural health providers and the communities they serve. During this 90-minute webinar, PYA's Martie Ross and Kathy Reep provided practical insights and advice for rural health leaders on the following topics: Impact of One Big Beautiful Bill on rural providers Impact of HHS restructuring on rural providers Key provisions of proposed 2026 Medicare payment rules  Current telehealth policy update Recent regulatory developments, including price transparency, HIPAA, EMTALA, Conditions of Participation, and more Federal enforcement activity What rural leaders need to know about Medicare Advantage This webinar is part of PYA's Let's Get Rural series, which reflects PYA's commitment to helping rural health providers preserve access to high-quality services for their communities. Check out all of PYA's Let's Get Rural webinars. PYA experts are committed to assisting with the unique needs of rural healthcare, including regulatory impacts, reimbursement opportunities, and any matter involving compliance, valuation, strategy, and transactions.

During this webinar, PYA's Barry Mathis explored the critical aspects of healthcare data breaches, focusing on understanding the immediate impacts, effective incident response steps, legal and regulatory requirements, communication strategies, long-term mitigation measures, and lessons learned from real-world case studies. The session aims to equip healthcare professionals with the tools and takeaways necessary to respond to data breaches effectively and mitigate future risks: An understanding of the multifaceted consequences of a data breach Practical steps for containment, eradication, and recovery Knowledge of HIPAA compliance and reporting obligations Ability to communicate transparently with patients, stakeholders, and the public Attendees learned from these educational objectives: Understand the immediate impact of a data breach, including financial, reputational, and operational consequences Learn effective incident response steps, including containment, eradication, and recovery Comply with legal and regulatory requirements, such as HIPAA compliance and timely reporting Develop communication strategies to notify affected parties and manage public perception Presented: Thursday, June 19, 2025

As we near our nation's 249th birthday, issues continue to heat up in Washington, D.C. During this one-hour webinar, PYA's Martie Ross and Kathy Reep addressed the most recent legislative, regulatory, and enforcement activities at the federal level: Updates on the One Big Beautiful Bill Act President's FY 2026 Budget Proposal Medicaid Provider Taxes and State-Directed Payments CMS Guidance: Price Transparency, EMTALA, Treatment for Gender Dysphoria Medicare Advantage Audits This webinar is part of PYA's twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments. If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, our executives are happy to assist. This webinar was presented Wednesday, June 25, 2025.

Tax planning becomes exceptionally challenging during non-consecutive presidential administrations because each administration may pursue vastly different fiscal philosophies, often reversing or modifying prior tax laws before they fully mature. Given that most tax legislation has built-in sunsets, phased-in provisions, or long-term implications, the lack of continuity in executive leadership can undermine stability and predictability. This political pendulum creates an environment of uncertainty for individuals and businesses alike, making it difficult to design long-term strategies with confidence. During this session, Joe, Patrick, and Victoria explained any remaining sunsetting provisions from the 2017 Tax Cuts and Jobs Act, provided insights into how changing tax laws, policy reversals, and legislative uncertainty impact planning strategies for individuals and businesses, and discussed legislation being considered by the Trump administration ("One Big Beautiful Bill"). By understanding the intersection of the budget reconciliation process and political cycles, you and your team will be better equipped to act in the most tax-efficient manner and adapt to evolving regulatory landscapes. Attendees learned from these key session objectives: • Identified how changes in presidential administrations impact long-term tax policy and planning • Analyzed the effects of temporary tax provisions and sunset clauses on strategic decision-making • Explained the role of budget reconciliation in shaping tax legislation • Explored various provisions of pending tax legislation • Evaluated the risks and uncertainties businesses and individuals face within politically volatile environments • Developed adaptable tax strategies that account for legislative reversals and partisan shifts

Third-Party Risk Management (TPRM) helps healthcare organizations reduce cybersecurity, compliance, and privacy risks posed by vendors and service providers. This webinar explains key TPRM program elements—including risk assessment, due diligence, and governance—and how they address HIPAA, FDA, and other regulatory requirements. Cyberattacks, ransomware, supply chain shortages, privacy breaches, and the resulting regulatory focus, fines, and penalties have all demonstrated the critical importance of a robust Third-Party Risk Management Program (TPMP) for healthcare entities of all sizes. During this session, Lori Foley discussed the key elements and importance of an integrated Third-Party Risk Management (TPRM) program, with an emphasis on the regulatory and compliance landscape. Specifically, attendees learned from these key points: Importance of TPRM in healthcare Brief overview of recent incidents or regulatory focus areas Definition and types of third parties (e.g., IT vendors, medical device manufacturers, outsourced service providers) Regulatory and compliance requirements pertaining to third-party vendors (e.g., BAAs, HIPAA, FDA) Core elements of a TPRM program lifecycle (inventory, risk assessment, due diligence, contracting, and ongoing monitoring) Coordination of parties in identification and mitigation of risks (e.g., internal audit, compliance, legal, quality, risk management, IT) Recommendations for appropriate governance oversight This was presented on Wednesday, June 18, 2025 12:30 pm – 1:30 pm E.T.