Monitor Mondays

Government agencies routinely publicize allegations and settlements. But convictions are different – and far more consequential. When a court reaches such a judgment, the warning is no longer theoretical. Understanding how and why entities or individuals are refunding money or serving prison time as result of valid evidence and the judgment of a court helps give a clearer awareness of regulatory and statutory guardrails. During the next live edition of the venerable Monitor Mondays weekly bro...

As expected, Monitor Monday continues to focus squarely on healthcare auditing and compliance. During the next live edition of the venerable Internet broadcast, Monitor Monday will examine a range of compliance and auditing concerns associated with skin lacerations. Led by esteemed physician and popular program special guest Dr. James S. Kennedy, the program will take listeners on a fascinating deep dive beneath the skin to explore documentation and reporting issues related to skin laceration...

Artificial intelligence (AI) is dramatically reshaping healthcare by accelerating data analysis, auditing, and documentation. But while it appears to reduce provider burden, AI also strengthens medical necessity support. What about compliance – and the role of human oversight? The producers of Monitor Mondays have invited senior compliance consultant Veronica Richardson with First Class Solution to report on current healthcare issues related to these compliance risks, plus essential tips for ...

There has been a noticeable recent surge of activity among data-mining companies or individuals who analyze publicly available government data for potential signals of fraud, rather than the insiders who have traditionally served as relators under the federal False Claims Act (FCA). As such, the venerable U.S. Department of Justice (DOJ) has a new process in place to mitigate the trend. It’s called Fraud Oversight through Careful Use of Statistics, (FOCUS), which will be the topic of a new r...

Program Update: CMS-2451-F has been published in the Federal Register. The proposed rule is effective Oct. 13, 2026. The recently posted rule prohibits federal and state Medicaid and CHIP program dollars from being spent on gender-affirming care for persons under 19 years of age. Earlier this year, CMS-3481-P —a related proposed rule— was reported by Drew Updike, MD, a senior healthcare consultant. That rule was published in mid-December 2025. During the next live edition of the venerable Mon...