• HIPAA Privacy Rule to Support Reproductive Healthcare Privacy Compliance
    May 12 2025
    In this episode of 1st Talk Compliance, Kevin Chmura is joined by Rachel Rose, JD, MBA, to discuss the HIPAA Privacy Rule to Support Reproductive Healthcare Privacy, passed in 2024. With the reproductive healthcare landscape being very dynamic, this new rule has already passed one compliance date, with a second important date coming in February 2026. Tune in to learn about this new rule, and what it means in terms of reproductive health, patient privacy, and the legality between different states. In addition, learn some best practices for implementing the requirements of this rule into your practice. Kevin Chmura Rachel, thank you for joining us. Appreciate you joining us and looking forward to a timely discussion. Rachel V. Rose Thank you, Kevin, for having me, as well as to Panacea and First Healthcare Compliance, it's always my pleasure to coordinate and converse with you on our favorite healthcare compliance topics. Kevin Chmura And it's always great having you helping us with this and your expertise is invaluable. And you helped us and were the contributor, really writer, of an e-book on this particular subject that will be released very soon. Really this podcast is somewhat of a companion piece to that. And so what we're talking about today is the HIPAA privacy rule to support reproductive health care privacy, passed in 2024. Reproductive health is a prominent and evolving topic within the healthcare policy landscape. It really, major changes have come down in recent years, and so there's just a ton. So we thought it would be great to publish a book to get everybody up to speed and, but moreover, this podcast is an opportunity for people to hear directly from the person who helped us develop that. And that is Rachel. So, Rachel, I wonder, can you just start off by giving us a synopsis of the 2024 Final Rule, maybe some key terms we should be thinking about? Rachel V. Rose Sure. As you mentioned, Kevin, the reproductive healthcare landscape is very dynamic and the rule itself was issued on April 22nd of 2024 with an effective date of June 25th of 2024. And basically what an effective date does is to start the clock running as to when certain requirements need to be implemented. In this particular rule, which I will refer to as the HIPAA Reproductive Rule, has two prongs of compliance dates. The first already passed and that had to be done by December 23rd, 2024. And for your clients who were with First Healthcare Compliance or Panacea at the time, they were able to access FAQs. And the first prong of the requirements really addressed every applicable item that I'll run through, with the exception of the notice of privacy practices. Now, for anyone who's been in the healthcare sector for a long time, and for anyone who goes to the doctor, a dentist or even a pharmacy to pick something up, we all know we have to sign the HIPAA authorization form, and then covered entities are required to post their notice of privacy practices. So the updated privacy practices, which need to include some of the reproductive health requirements among other items, does not need to be done until February 16 of 2026. So this is similar to the staggering of the compliance dates which we saw with the Final OmnibusRrule, which was published in the Federal Register, it's hard to believe, but going on over 12 years ago and that was January 25th of 2013. Now specifically, the HIPAA reproductive rule really prohibits the disclosure of protected health information related to in these terms I need you to focus on: lawful reproductive health care in certain circumstances. And the reason it's important is because legal means that whatever service or good is being sought, it has to be legal within the jurisdiction where the individual is receiving that care or that good, so to speak. And so if we want to take certain types of surgeries or certain types of procedures that in a viable fetus’s lif...
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    20 mins
  • RE-RELEASE Employee Snooping & Insider Threats
    Mar 18 2025
    In this episode of 1st Talk Compliance, guest Raymond Ribble, CEO and Founder at SPHER, Inc., discussed guidelines and procedures to help protect your organization from actions of malicious employees.
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    29 mins
  • RE-RELEASE Mastering Defensible Pricing in the Era of Price Transparency
    Feb 19 2025
    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.
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    16 mins
  • RE-RELEASE The Sky’s the Limit: How Price Transparency Can Empower Healthcare Providers
    Feb 18 2025
    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 the future of price transparency. We’ll also include some key resources for listeners hoping to boost their knowledge of CMS price transparency regulations and learn how they can leverage price transparency data to empower their own strategic initiatives.
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    27 mins
  • New HCPCS Code Requirements for Supplies: Managing Your CDM to Avoid Claim Denials
    Feb 3 2025
    In this episode of 1st Talk Compliance, Kevin Chmura and BreAnn Meadows discuss the challenges healthcare providers face due to payers increasingly denying claims for supplies that are missing HCPCS codes. The issue stems from recent payer policy changes, with supplies that were previously chargeable now being rejected if they lack a corresponding HCPCS code. The conversation tackles the complexities providers face in managing their chargemaster (CDM), maintaining accurate HCPCS coding, and addressing claim denials, which can result in lost revenue. Tune in to equip yourself with actionable strategies to avoid claim denials, as Bre underscores the importance of adopting a strategic, focused approach to managing your CDM, adapting to evolving payer practices, and staying proactive in compliance efforts.
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    16 mins
  • The Two-Midnight Rule: Navigating the Complexities and Achieving Compliance
    Jan 8 2025
    The Centers for Medicare and Medicaid Services (CMS) recently released additional guidance on the Two-Midnight rule that carries important implications for hospitals seeking to apply the rule correctly and consistently. In this episode of 1st Talk Compliance, host Kevin Chmura is joined by Stacy Pereira, Executive Director of Coding and Clinical Services in Panacea’s KA Consulting Division, to continue the discussion surrounding the Two-Midnight rule and the challenges it poses. If you enjoyed Panacea’s recent webinar on the topic, or you’re simply looking for more information on how the rule might impact you, tune in for a deep dive into the potential challenges involved for hospitals seeking to apply the rule correctly, possible financial impacts of the rule’s enforcement, and pitfalls of over- or underusing observation status. In case you missed our webinar on the Two-Midnight rule, you can watch it on-demand here.
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    19 mins
  • Delivering Innovative Solutions: A Conversation with Panacea’s Newest Division President
    Oct 14 2024
    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 services, and revenue integrity solutions, KA Consulting has earned a reputation for providing solutions that go the extra mile to obtain appropriate reimbursement and to improve compliance. We are thrilled to welcome them as a division of Panacea Healthcare Solutions, further enhancing our commitment to delivering industry-leading healthcare financial, revenue integrity, and clinical solutions nationwide. Tune in to get the inside scoop on this latest development as Kevin and George delve into KA’s background and our shared history and discuss how our newly combined expertise complements each other’s teams.
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    24 mins
  • The Role of Compliance Programs in Mitigating False Claims Act Liability
    Jul 26 2024
    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 of 1st Talk Compliance, Rachel Rose, JD, MBA discusses recent key developments in the False Claims Act landscape and shares tips on how healthcare providers can enhance their compliance strategies and mitigate regulatory risks. Tune in to gain a comprehensive understanding of the False Claims Act and its role in the healthcare sector, hear updates on several recent significant fraud, waste, and abuse cases, and receive actionable insights into bolstering your organization’s compliance initiatives.
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    1 hr and 2 mins