Episodios

  • Part 2: Learnings and Insights from the St. Peter's Health Settlement and DOJ False Claims Act Case with Dr. Tom Weiner
    Sep 18 2024

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    “Bob, I think we have a big problem on our hands.” In this episode, Captain Integrity Bob Wade continues his discussion of the facts and insights from the St. Peter's Health Settlement and DOJ (Department of Justice) False Claims Act case with Dr. Tom Weiner. Hear how to act with integrity, know when a case should be bifurcated, revamp your compliance program, why the DOJ got involved, and why the saga continues with this case. Learn more at CaptainIntegrity.com

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    29 m
  • Part 1: Learnings and Insights from the St. Peter's Health Settlement and DOJ False Claims Act Case with Dr. Tom Weiner
    Sep 11 2024

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    And it all started with a Fair Market Value (FMV) defensibility analysis. In this episode, Captain Integrity Bob Wade discusses the facts and insights from the St. Peter's Health Settlement and DOJ (Department of Justice) False Claims Act case with Dr. Tom Weiner. Hear why there should be heightened scrutiny with a Lone Wolf, why you need to pay special attention to a high producer, why most of the services a specialist provides should be in their specialty, the most shocking findings from the case, and Bob’s role in the case. Learn more at CaptainIntegrity.com

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    24 m
  • Back to the Future with Chevron Deference: A Discussion with Phillip Mullinnix, Partner at Nelson Mullins
    Aug 28 2024

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    Let’s go Back to the Future. In this episode, Captain Integrity Bob Wade “time travels” to all things Chevron deference with Phillip Mullinnix, Partner at Nelson Mullins. Hear why prior court rulings are up for grabs, where to expect more litigation, where to expect lengthy legislation, the history of the Chevron case, and some Back to the Future movie trivia. Learn more at CaptainIntegrity.com

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    16 m
  • Algorithmic Pricing, a New Compliance Risk: A Discussion with Bart Daniel, Partner at Nelson Mullins
    Aug 21 2024

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    Emails are evil. In this episode, Captain Integrity Bob Wade explores the new compliance risk of algorithmic pricing with fan-favorite Bart Daniel, Partner at Nelson Mullins. Hear why you should beware of algorithmic pricing, beware of Private Equity (PE), examine the reimbursement rates closely, how to turn your expense department into a revenue department, and why enforcing algorithmic pricing is a top priority. Learn more at CaptainIntegrity.com

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    22 m
  • Mission Improbable: A Discussion with Kay Hashagen, Senior Consultant with LW Consulting, about the Impossible Day
    Aug 14 2024

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    The Improbable Day or Impossible Day is a major compliance issue. In this episode, Captain Integrity Bob Wade chats these scenarios with Kay Hashagen, Senior Consultant with LW Consulting. Hear how to avoid an Improbable Day or Impossible Day scenario, why you should do scheduling audits, why the best defense is a strong offense, the biggest red flags with these scenarios, and a little Tom Cruise and Sherlock Holmes. Learn more at CaptainIntegrity.com

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    20 m
  • Open Payments: A Conversation with Aaron Narva, CEO of Conflixis, Regarding Compliance Findings and Nature of Reported Payments
    Aug 7 2024

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    Data is endlessly impactful in the healthcare space. In this episode, Captain Integrity Bob Wade discusses open payments and compliance findings with Aaron Narva, Co-Founder and CEO of Conflixis. Hear why you shouldn’t underestimate the impact of conflicts in your organization, how your data is available and under scrutiny, why understanding your data can be your secret weapon, some staggering numbers from The Open Payments Report, and how commercial reasonableness (CR) plays into healthcare payments. Learn more at CaptainIntegrity.com

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    30 m
  • Designated Health Services (DHS): The Key to the Stark Law City
    Jul 24 2024

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    A referral by a physician of a Designated Health Service (DHS) is the key to opening up the Stark Law City. In this episode, Captain Integrity Bob Wade explains what a DHS is and how they’re categorized. Hear why you should add the CMS (Centers for Medicare & Medicaid Services) website page about the Stark Law to your Favorites, which Stark Law categories are defined by the CPT/HCPCS code, the scenarios where the Stark Law doesn’t apply, what defines a DHS, and the time Captain Integrity got the Key to the City. Learn more at CaptainIntegrity.com and email Bob to get the slide

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    22 m
  • Corporate Integrity Agreements (CIAs) and Independent Review Organizations (IROs): A Discussion with Harriett Wall, CEO of LW Consulting, Inc.
    Jul 17 2024

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    Move it to an asset rather than a liability. In this episode, Captain Integrity Bob Wade talks Corporate Integrity Agreements (CIAs) and Independent Review Organizations (IROs) with Harriett Wall, President and CEO of LW Consulting, Inc. Hear how to avoid CIAs with a strong compliance program, why an IRO should be open to input, how to embrace a CIA for change, whether an OIG Monitor (Office of Inspector General) is a friend or foe, and a Lion King reference from Captain Integrity. Learn more at CaptainIntegrity.com

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    26 m