Best Aca Compliance Podcasts (2023)

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NFP's Insights from the Experts

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EP 138: Preventive Care Litigation, HSA Updates and Some Interesting Issues on Form 5500 Schedule As 19:48

2h ago19:48

19:48

In this episode, Chase Cannon and Suzanne Spradley discuss updates on the ACA preventive care mandate litigation, including a stay issued by the Fifth Circuit Court of Appeals. HSA contribution limits become a topic of discussion, as the IRS recently published updated numbers. Chase and Suzanne also discuss a common problem for employers filing For…

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Business of Health with Mike Martens

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Nancy Giacolone: Key Ingredients to a Better Small Group Health Plan 27:28

7h ago27:28

27:28

Nancy Giacolone is a seasoned insurance broker with over 30 years of experience in the industry. As the President of Olympic Crest Insurance, she specializes in providing health insurance solutions for small businesses. As a certified Health Rosetta Benefits Associate Advisor, Nancy is committed to providing her clients with exceptional service and…

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NFP's Insights from the Experts

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EP 137: National Debt, Debt Ceilings and the Impact on Healthcare and Group Health Plans 19:04

8h ago19:04

19:04

In this episode, Suzanne Spradley and Chase Cannon have a look at the national debt and debt ceiling and how they impact employers and their group health plans. Suzanne leads off with a discussion on the national debt and how Congress sets the debt ceiling. Suzanne and Chase go in depth on what a failure to raise the debt ceiling and/or default on …

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Business of Health with Mike Martens

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Al Kushner: Understanding Medicare 28:56

14d ago28:56

28:56

Al Kushner is a recognized Financial Educator, Author, Speaker, Retirement Specialist, and the Founder of Superior Mutual Inc. He specializes in Medicare plans and represents national and regional carriers. Today, he joins Mike today to talk about Medicare. They highlight the most common mistakes made by individuals during the Medicare sign-up proc…

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NFP's Insights from the Experts

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EP 136: Recent HIPAA Violation Settlements from OCR 28:55

14d ago28:55

28:55

In this episode, Chase Cannon and Suzanne Spradley review several recent HIPAA violation settlements from the HHS Office for Civil Rights. Chase starts off by reviewing the general HIPAA obligations of fully and self-insured plans, including the importance of a HIPAA risk assessment. Chase and Suzanne discuss three real-life scenarios outlining way…

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Business of Health with Mike Martens

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Todd Archer: Understanding Reference Based Pricing (RBP) 26:49

1M ago26:49

26:49

Todd Archer is the President of Concierge Third Party Administrator, a company recognized as one of the nation’s premier industry leaders in third-party administration of self-funded health benefit plans for employer groups of all sizes. With over 35 years of experience, Todd has a proven track record in the field of health benefits third-party adm…

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NFP's Insights from the Experts

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EP 135: Texas Court Invalidates a Portion of the ACA’s Preventive Services Coverage Requirement 20:16

2M ago20:16

20:16

In this episode, Suzanne Spradley and Chase Cannon discuss a recent Texas court ruling that invalidates a portion of the ACA’s preventive services coverage requirement. Suzanne provides a background of the plaintiffs and their arguments, including a Constitutional problem with the way the government appointed officers under the ACA and a religious …

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Business of Health with Mike Martens

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Stacy Barrow: Employee Benefit Issues During Acquisition 22:02

2M ago22:02

22:02

Stacy Barrow is a Partner at Barrow Weatherhead Lent LLP, and one of the nation’s leading experts on the Affordable Care Act. He uses a practical, business-focused approach to counsel his clients on all matters related to employee benefit plans. Today, Stacy and Mike discuss the complexities of mergers and acquisitions, particularly how two groups …

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K&L Gates Health Care Triage

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2022 Health Care Employment Law Year in Review 22:09

1M ago22:09

22:09

In this episode, Sarah Carlins and Spencer Hamer discuss employment law and the health care sector. They review highlights from 2022, as well as developments that will impact employment law and the health care sector in 2023, including vaccine mandates, telehealth regulations, pay equity, and health care staffing regulations.…

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K&L Gates Health Care Triage

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Rural Emergency Hospitals — Transformative Change or Limited Impact? 17:14

2M ago17:14

17:14

In this episode of Triage, Andrew Ruskin, Darlene Davis, and Gabriel Scott discuss key provisions associated with conversion to CMS’s new rural emergency hospital provider type. They review the purpose of the new provider type, considerations and requirements for converting, as well as the benefits and drawbacks of a transition to a rural emergency…

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Business of Health with Mike Martens

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Dr. Josh Umbehr, MD: The Measurable ROI Using Direct Primary Care in Your Health Insurance Plan 28:23

2M ago28:23

28:23

Dr. Josh Umbehr is a board-certified family practice physician and the Founder and Owner of Atlas MD, a membership-based direct primary care practice company providing family healthcare that is immediate, thorough, comprehensive, specific, easily affordable, and personal. Today, Dr. Josh and Mike discuss how the U.S. healthcare system is broken and…

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NFP's Insights from the Experts

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EP 134: IRS Mandates Electronic Filing for Smaller Employers 16:08

2M ago16:08

16:08

In this episode, Chase Cannon and Suzanne Spradley address recent IRS guidance that mandates electronic filing of certain tax forms – including Forms 1095-C – for smaller employers. Chase describes the background from Congress and the IRS and explains what it means now that any employer filing 10 or more forms (previously, this was 250) will be req…

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Business of Health with Mike Martens

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Kyle Estep: Exploring the Benefits of ICHRA 34:00

2M ago34:00

34:00

Kyle Estep is the Vice President of Growth at Take Command Health, a company offering an end-to-end Individual Coverage Health Reimbursement Arrangement (ICHRA) platform solution for employers adopting the new individual coverage reimbursement model of employee benefits. In this episode, Mike and Kyle discuss the health care policy landscape, the i…

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NFP's Insights from the Experts

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EP 133: PBM Transparency: Potential State and Federal Activity 24:35

2M ago24:35

24:35

In this episode, Suzanne Spradley and Chase Cannon discuss potential activity at the federal and state level relating to PBM transparency. Suzanne begins the discussion by outlining a few proposals from Congress that attempt to hold PBMs accountable for unfair and deceptive practices that may be driving up prescription drug costs. Suzanne then addr…

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Business of Health with Mike Martens

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Mike Martens: The Great ICHRA Disruption 8:39

3M ago8:39

8:39

Mike Martens explains voluntary disruption today. This important concept is about enabling employees to pick the health insurance they prefer with payroll deduction benefits. Between 2020 and 2022, businesses offering ICHRA escalated by three and a half times. In order to take full advantage of ICHRA (Individual Coverage Health Reimbursement Arrang…

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NFP's Insights from the Experts

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EP 132: Public Health Emergencies, Telehealth Extensions & State Compliance Considerations – 2023 26:03

3M ago26:03

26:03

In this episode, Beth Allen and Chase Cannon look at several new developments for plan compliance in 2023. The two start with the recent announcement on the end of the COVID-19 public health emergency, which impacts the outbreak period and extension of timeframes for certain compliance deadlines. Chase then dives in on the CAA 2023 extension of rel…

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Business of Health with Mike Martens

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Janet Trautwein: Post Mid-Term Election Congressional Update 25:44

4M ago25:44

25:44

Janet Trautwein is the Chief Executive Officer of the National Association of Benefits and Insurance Professionals and President of the National Association of Benefits and Insurance Professionals Foundation in Washington, D.C. Janet is a highly saught-after speaker who focuses on health insurance markets, the uninsured, risk pooling, and tax issue…

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K&L Gates Health Care Triage

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Stark Law and the Anti-Kickback Statute Under the False Claims Act 21:46

4M ago21:46

21:46

In this episode, Norman Acker, Nora Becerra, and Katherine Rippey discuss the False Claims Act as it relates to Stark Law and the Anti-Kickback Statute. They analyze the Wheeling Hospital case and the Catholic Medical Center case and discuss key takeaways from the cases as they relate to the False Claims Act.…

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NFP's Insights from the Experts

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Ep 131: Healthcare Policy and Compliance Issues for Employers to Consider in 2023 24:25

5M ago24:25

24:25

In this episode, Suzanne Spradley and Chase Cannon highlight several areas of healthcare policy and compliance that will be on center stage in 2023. Suzanne starts with a discussion of transparency in healthcare and prescription drug costs, including several compliance requirements that will take effect in 2023. Suzanne and Chase discuss state comp…

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K&L Gates Health Care Triage

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Recent Developments to the 340B Drug Pricing Program 11:10

5M ago11:10

11:10

In this episode Victoria Hamscho, Andrew Ruskin, and Leah Richardson provide an update on key developments to the 340B Program. They discuss the effects of the Supreme Court’s decision earlier this year overturning 340B hospital reimbursement cuts, the agency’s proposed rule with respect to hospital outpatient reimbursement, and some considerations…

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Business of Health with Mike Martens

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Danny Creed: Power of Words and the DISC Personality System 28:47

5M ago28:47

28:47

Danny Creed is a certified business executive, sales coach, and bestselling author. He is the seven-time winner of the Brian Tracy Award for Sales Excellence. Danny is also a celebrity coach and the founder of the Danny Creed Group. This episode is about The benefits of using the DISC system in various areas of life. Danny Creed learned about The b…

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Business of Health with Mike Martens

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David Smith: The Growth of "Wearable" Technology 24:33

6M ago24:33

24:33

David Smith is the president and chief revenue officer of Ilumivu. Ilumivu is a company that was founded in 2009 that provides technology and research for wearable devices. These devices are used to help people with things such as mindfulness, meditation, and behavioral and mental health. David Smith has led sales at Fortune 5 companies (Optum/Unit…

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K&L Gates Health Care Triage

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The Information Blocking Rule's "Glide Path" - Compliance with the Information Blocking Rule After the Limitation on the Scope of EHI is Lifted 26:42

5M ago26:42

26:42

In this episode, Gina Bertolini and Stephen Page discuss the most recent Information Blocking Rule compliance deadline. Using a recent letter from several health care providers and other stakeholders to the Office of the National Coordinator for Health IT (ONC) that outlines concerns related to the Information Blocking regulations, Gina and Stephen…

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Business of Health with Mike Martens

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Elizabeth Raggio: Changes to IRS ACA Reporting 32:27

6M ago32:27

32:27

When you work with an employer or group that has 50 or more employees, at some point, you will need to understand the process of responding to IRS notifications - a process that Elizabeth Raggio walks us through in this episode. In this episode you will learn: Elizabeth Raggio is a compliance attorney with the ETC company. She has been with ETC sin…

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K&L Gates Health Care Triage

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New Data Available Under the Hospital Price Transparency Rule 17:42

6M ago17:42

17:42

In this episode, Darlene Davis, Andrew Ruskin, and Lauren Norris Donahue review data that is now available in light of the hospital price transparency rule. They discuss the recent increase in compliance among hospitals, benefits of hospital price transparency data, antitrust considerations, and suggestions for hospitals to implement guidelines for…

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NFP's Insights from the Experts

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Ep 130: More COBRA Cases — Class Actions and COBRA Election Notices 18:37

7M ago18:37

18:37

In this episode, Suzanne Spradley and Chase Cannon discuss several recent COBRA cases. Suzanne starts by outlining several class action lawsuits filed against employers and plan sponsors relating to deficiencies in an employer health plan’s COBRA election notice. Suzanne and Chase discuss the use of the DOL’s Model Election Notice and how that usag…

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Business of Health with Mike Martens

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The Key Ingredients to Maximize Enhanced Benefits ft. Eric Silverman 32:13

7M ago32:13

32:13

In this episode, Mike Martens welcomes Eric Silverman, one of the most innovative and influential brokers in the industry today. Eric explains the right terms applicable to enhanced benefits, which are usually provided for by the company to their employers. As an expert on employer-funded benefits, Eric shares his insights on the difference between…

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NFP's Insights from the Experts

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Ep 129: Recent Court Rulings on COBRA and the ACA 22:44

7M ago22:44

22:44

In this episode, Chase Cannon and Suzanne Spradley discuss three recent court rulings—all at the district court level. Chase outlines the first case relating to a COBRA election notice failure, including takeaways for employers to enhance their notice distribution procedures. Chase and Suzanne dive into an ACA-related case challenging gender-affirm…

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Business of Health with Mike Martens

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Solving the Disconnect in Healthcare Technology ft. Stephen Dean 23:16

7M ago23:16

23:16

Stephen Dean co-founded Keona Health to simplify the tedious process that providers have to go through with healthcare technology. With his background in information technology, Stephen and his co-founders came up with a systematic customer relationship software built for healthcare. In this episode, Mike and Stephen discuss the major disconnect in…

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Business of Health with Mike Martens

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NAHU CEO Addresses the Health Care Issues Ft. Janet Trautwein 21:36

8M ago21:36

21:36

Janet Trautwein is the Chief Executive Officer of the National Association of Health Underwriters (NAHU). Also serving as the president of the NAHU Education Fund in Washington DC, she oversees the activities affiliated with employee benefits programs in the design, implementation and management of health plans. Janet shares details about the NAHU’…

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NFP's Insights from the Experts

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Ep 128: Fall Bills: Congress Considers Mental Health Services Proposals 20:03

8M ago20:03

20:03

In this episode, Suzanne Spradley and Chase Cannon walk through recent activity in the House and Senate relating to several new laws under consideration on coverage of mental health services. Suzanne starts by reviewing some potential changes relating to Medicare coverage of mental health services, such as required behavioral health monitoring for …

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K&L Gates Health Care Triage

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Issue-Spotting Hospital Activities that May Trigger FDA Regulatory Oversight 16:11

8M ago16:11

16:11

In this episode, Rebecca Schaefer and Michael Hinckle review some types of hospital and health system activities that could trigger FDA regulatory oversight. They discuss the FDA’s jurisdiction over IRB’s in medical device clinical trials, sponsor obligations for investigator-initiated studies, and compliance for expanded access INDs and for GMPs i…

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Business of Health with Mike Martens

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Amp up your Client’s EAP ft. John Troutman 25:06

8M ago25:06

25:06

The pandemic has seen a global spike for solutions to address mental health issues. Whether the issues stem from personal or work-related causes, solutions need to be accessible for people and organizations that need them most. In this episode, Mike welcomes John Troutman, the National Marketing Director for Mazzitti and Sullivan EAP Services. They…

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NFP's Insights from the Experts

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Ep 127: Benefits Aspects of the Inflation Reduction Act 17:24

9M ago17:24

17:24

In this episode, Chase Cannon and Suzanne Spradley discuss the benefits provisions of the recently-enacted Inflation Reduction Act. Chase walks through the extension of premium tax credit expansions through 2025, and the impact on employers with respect to the employer mandate penalties. Next, Chase and Suzanne discuss Medicare prescription drug co…

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K&L Gates Health Care Triage

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Cybersecurity & HIPAA: NIST’s Practical Guidance Updates for Covered Entities and Business Associates 12:10

9M ago12:10

12:10

In this episode, Rebecca Schaefer and J.D. Koesters review key components of the recent National Institute of Standards and Technology (NIST) revised publication regarding cybersecurity. They highlight how this resource incorporates NIST security lessons from other industries and maps the guidance to compliance requirements under the HIPAA Security…

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K&L Gates Health Care Triage

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Genesis Healthcare and the 340B Program Patient Definition 9:56

10M ago9:56

9:56

In this episode, Andrew Ruskin, Leah Richardson, and Victoria Hamscho analyze the U.S. Court of Appeals for the Fourth Circuit’s recent decision in Genesis Healthcare v. Becerra. They discuss its potential impact on the Health Resources and Services Administration’s definition of a 340B eligible patient in light of recent developments in the 340B P…

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Business of Health with Mike Martens

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Set up for Success ft. Danny Creed 25:32

10M ago25:32

25:32

The pandemic brought devastating challenges to many industries and individuals. For Danny Creed and his clients, the last two years brought an opportunity for growth. As a professional and certified business and executive coach, Danny encourages his clients to bear a positive mindset and maintain an enthusiastic attitude in any phase and facet in t…

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K&L Gates Health Care Triage

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Medicare Advantage False Claims Act Developments 18:26

10M ago18:26

18:26

In this episode, Stephen Bittinger and Nathan Huff discuss the growth of Medicare Part C (Medicare Advantage), new enforcements for Medicare Advantage Organization fraud, recent cases of False Claims Act liability, and key takeaways for Medicare Advantage Organizations and providers.

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Business of Health with Mike Martens

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Managing ERISA Reporting Profitability ft. Jay Rodney 16:57

10M ago16:57

16:57

Jay Rodney is the co-founder and CEO of RTO Benefits LLC. The company specializes in developing custom solutions, compliance documents, and nondiscrimination testing for their clients in all markets. Jay explains how his company streamlines the tedious process and crucial documentation that employers have to go through for their extensive and inclu…

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Business of Health with Mike Martens

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Managing ACA IRS filings ft. Matt Scott 30:20

10M ago30:20

30:20

How long does the IRS notify companies about possible penalties? ETC Companies Director of Sales Matt Scott knows the timeline and the exact ways to prevent and reduce them. Serving clients in Houston, Texas and beyond, ETC Companies assists employers in their ACA IRS filing. While the IRS’ response can lead up to two years from the filing date, ev…

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NFP's Insights from the Experts

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Ep 126: Post-Dobbs Executive Orders, HHS Guidance and State Developments 18:30

10M ago18:30

18:30

In this episode, Chase Cannon and Suzanne Spradley recap the past few weeks’ guidance relating to Post-Dobbs considerations on employer coverage and reimbursement of abortion-related services. Chase starts by comparing the approaches of two different states – Texas and New Jersey – with respect to the legality of abortion services. New laws and dev…

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Business of Health with Mike Martens

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About the Business of Health & Mike Martens 4:33

11M ago4:33

4:33

Mike Martens has spent the last 37 years of his life gaining knowledge and enhancing his expertise in the health and insurance industry. As a way of giving back for the success he achieved and the opportunities he received, he is launching the Business of Health Podcast. This show aims to become a resource for insurance advisers and companies to ge…

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K&L Gates Health Care Triage

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Hospitals, Physician Practices, and Labs – Are You Ready to Report Private Payor Rates for Laboratory Tests? 14:27

11M ago14:27

14:27

In this episode, Gabriel Scott and Darlene Davis analyze the private payor rates reporting requirements under the Protecting Access to Medicare Act. They discuss the type of entities required to report, potential penalties for failing to report, and provide some suggestions for how to initiate the reporting process.…

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NFP's Insights from the Experts

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Ep 125: FMLA and Mental Health 16:13

12M ago16:13

16:13

In this episode, Suzanne Spradley and Patrick Myers discuss recent guidance concerning the interaction between FMLA and mental health conditions. Suzanne provides some context for this guidance and a brief refresher on FMLA itself. Suzanne and Patrick then discuss how mental health conditions can apply in a FMLA context, including when a mental hea…

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K&L Gates Health Care Triage

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The Drive to Align ESG and Health Equity Priorities With Medicare Reimbursement Models 11:57

11M ago11:57

11:57

Steve Pine and Alexa Sengupta address the Centers for Medicare and Medicaid Services’ emerging focus on ESG and health equity priorities, and how these priorities are impacting health data collection and Medicare value-based reimbursement models.

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NFP's Insights from the Experts

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Ep 124: Hospital Prices and Group Health Plan Costs 17:52

1y ago17:52

17:52

In this episode, Suzanne Spradley and Chase Cannon discuss hospital prices and their impact on employer group health plans. Suzanne describes this issue as it relates to the new transparency in coverage rules. Suzanne and Chase review a recent study that reviews hospital prices nationwide, including Medicare-certified, short-stay and other facility…

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NFP's Insights from the Experts

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Ep 123: Point Solution Programs and Compliance Issues 21:30

1y ago21:30

21:30

In this episode, Chase Cannon and Suzanne Spradley look at the recent rise in so-called “point solution programs.” These add-on programs enhance or expand on a group health plan offering and have benefits such as mental health, musculoskeletal, life coaching and fertility. Chase explains some of the compliance challenges that arise from offering th…

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K&L Gates Health Care Triage

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Regulatory, Contractual, and Governance Considerations for Data Transactions 28:29

1y ago28:29

28:29

In this episode, Rebecca Schaefer and Gina Bertolini discuss the incredible value of health care data and how providers can harness the power of data transactions to drive innovation, discovery, and advancements in medical therapies.

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NFP's Insights from the Experts

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Ep 122: Transparency in Coverage Updates 24:04

1y ago24:04

24:04

In this episode, Suzanne Spradley and Chase Cannon update us on employer compliance obligations under the Transparency in Coverage (TIC) rules. Suzanne begins with an overview of the TIC rules and how they are meant to address consumerism and rising health care costs. Suzanne and Chase then hone in on the actual requirements, including posting of p…

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K&L Gates Health Care Triage

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Medical Laboratories Under the Microscope 20:00

1y ago20:00

20:00

In this episode, Myla Reizen, John Lawrence, and Bobby Higdon analyze the increase in governmental scrutiny around laboratory investigations and enforcement. They discuss the Eliminating Kickbacks Recovery Act (EKRA), trends in enforcement surrounding Operation Double Helix, guidance for medical labs, and the importance of outside counsel for compl…

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