Episodes
-
Send us Fan Mail
In Chattanooga, trains are famous for staying on the tracks. In this episode, Captain Integrity Bob Wade explores whether Compliance stayed on the tracks in the Erlanger case. Hear why you need to listen to people who are making reports to you about physician compensation, why total cash compensation is king, how thereâs a direct linkage between coding & billing results and physician compensation, the speeding ticket analogy for the Erlanger case, and the interesting things Chattanooga is known for. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Lean in wherever you have quick wins. In this episode, Captain Integrity Bob Wade talks using AI in physician contracting & payment as they relate to the Stark Law with Scott Lowry, Founder of StarkWatch. Hear how to quickly assess where your organizationâs at with its Stark Law compliance program, how to aim for advancement instead of program perfection, why you should use inexpensive AI solutions to perform reviews & monitoring, some of the use cases for StarkWatch, and a bit of nostalgia for old school, offline resources. Learn more at CaptainIntegrity.com
-
Missing episodes?
-
Send us Fan Mail
Training goes a long way when it comes to informed consent. In Part 3 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear why you need to document the decision-making capacity, how to make sure AI use is properly disclosed, why policies & procedures play a huge role, how AI is changing the healthcare world, and how surrogates work. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
The more checks and balances an organization has along the way, the greater the protection for both the patients & the providers. In Part 2 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear how decision-making capacity & inadequate informed consent lead to legal liability, considerations when it comes to anesthesia, personal anesthesia stories from Bob & Rachel, the best practices organizations can take to uphold patient autonomy, and notable high-profile cases involving sexual assault. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
The patentâs right to autonomy is one of the core principles of the patient-provider relationship. In Part 1 of this 3-part episode, Captain Integrity Bob Wade talks informed consent, decision-making capacity, and surrogates as they relate to the Stark Law with Attorney Rachel Rose. Hear the recent cases where informed consent & decision-making capacity were relevant, the difference between decision-making capacity & informed consent, why having the piece of paper signed doesnât necessarily mean informed consent, how providers & patients can protect themselves, and what you should think through as a patient before moving forward with anything. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
You should be able to duct tape your mouth & hands and give your documentation to the payer, and they should still be able to generally understand what happened. In Part 2 of this 2-part episode, Captain Integrity Bob Wade continues his discussion on holistic audits and synchronizing professional & facility reviews under the Stark Law with Kelly Loya & Bruce Truitt of Pinnacle Enterprise. Hear how to consider all entities of the claim, when to consider unified sampling, how to help payers, how the 60-day overpayment rule works, and how to handle the discussion that the file is closed. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
You canât audit the whole ocean. In Part 1 of this 2-part episode, Captain Integrity Bob Wade discusses holistic audits and synchronizing professional & facility reviews under the Stark Law with Kelly Loya & Bruce Truitt of Pinnacle Enterprise. Hear what holistic audits are, the different types of reviews, the benefits of sampling a patient encounter, how to maintain an unbiased sample, and the parable of the blind men and an elephant. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
There is indeed a return on investment (ROI) for an effective compliance program. In this episode, Captain Integrity Bob Wade quantifies that ROI as it relates to the Stark Law. Hear why the ROI can be 2x-5x what the organization is investing, how the cost for non-compliance is 2x-3x higher, why you shouldnât look at the compliance program as just a cost center, examples of compliance program ROI calculations, and your ROI if you would have invested in Apple & Disney in the early days. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
When analyzing a physician financial arrangement under the Stark Law, you also need to analyze it under the Anti-Kickback Statute (AKS). In this episode, Captain Integrity Bob Wade explains why most of the exceptions under the Stark Law cross-reference the Anti-Kickback Statute. Hear all about the Stark Law & Anti-Kickback Statute dance, the 3 ways to meet the definition of not violating the Anti-Kickback Statute, how to ensure your team understands the intent basis under the Anti-Kickback Statute, specific definitions to keep in mind, and what the Stark Law & Anti-Kickback Statute have to do with The Wizard of Oz. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
The definition of an âEntityâ under the Stark Law includes Managed Care Organizations (MCOs) and the Anti-Markup Rule. In this episode, Captain Integrity Bob Wade details this âEntityâ definition under the Stark Law. Hear who the âEntityâ usually is, why they expanded the definition, the very narrow exception they came up with, examples of an âEntityâ in action, and Bob recite some Miranda Lambert lyrics. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
When a physician doesnât perform 100% of the services covered by a surgical period, you may have to consider splitting out the global wRVUs. In this episode, Captain Integrity Bob Wade talks global wRVUs and personally performed services as they relate to the Stark Law. Hear the 3 separate categories when a service is covered by a global payment, what happens when a physician didnât technically perform all the services for a global payment, when itâs possible the physician could be compensated above fair market value (FMV), a little bit of wRVU math, and some interesting facts about Around the World in 80 Days. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
False Claims Act settlements (FCA): they just keep getting bigger. In this episode, Captain Integrity Bob Wade details the notable False Claims Act settlements for 2025. Hear how qui tam cases continue to represent the largest source of settlements through the Department of Justice (DOJ) and False Claims Act, what it means if the government declines to intervene, why medical necessity continues to be a very large focus, a shocking settlement involving a physician, and fun examples of things that just keep getting bigger. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
There are some uses of the isolated transaction exception that are prohibited under the Stark Law. In this episode, Captain Integrity Bob Wade dives into that isolated transaction exception. Hear why the isolated transaction exception has been expanded, the times when it can be used for service arrangements, how it can be used for settlement of a bona fide dispute, the nuances of the isolated transaction exception, and the history of the famous song, âAll by Myself.â Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Beware of the enemy within. In Part 2 of this 2-part episode, Captain Integrity Bob Wade talks cybersecurity and the False Claims Act (FCA) with returning guest and Nelson Mullins Partner Bart Daniel. Hear how to guide outside contractors through certification, why you need to monitor & protect any vulnerabilities as they arise, how to disclose any shortcomings when discovered & be cooperative, where cybersecurity fits in the Top 3 enforcement priorities for the False Claims Act, and how to go about vulnerability testing. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Cybersecurity and the False Claims Act (FCA) have more in common than you think. In Part 1 of this 2-part episode, Captain Integrity Bob Wade talks cybersecurity and the False Claims Act with returning guest and Nelson Mullins Partner Bart Daniel. Hear the history of the False Claims Act, fascinating stats on whistleblowers, the impact of Trumpâs executive order on cybersecurity from June 2025, the certifications needed in cybersecurity, and some delicious candy bar history. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
There are some exceptions to the broad definition of an ownership interest under the Stark Law. In this episode, Captain Integrity Bob Wade explains what are not ownership interests under the Stark Law. Hear why the definition does have exceptions, how most of the exceptions are deemed to be compensation arrangements, how to treat an unsecured loan, the 7 types of exceptions, and the original version of âThe devil is in the details.â Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Understanding the definition of an ownership interest is crucial under the Stark Law. In this episode, Captain Integrity Bob Wade shares why loans are ownership interests under the Stark Law. Hear why you need to know & understand all definitions under the Stark Law, why ownership interests also include loans & bonds under the Stark Law, why you should always self-report, key takeaways from a recent Stark Law settlement, and the history of the âWhen in Romeâ proverb. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Artificial Intelligence (AI) needs a little pushback. In Part 2 of this 2-part episode, Captain Integrity Bob Wade continues his talk on the intersection of AI, Fair Market Value (FMV), the Stark Law, and the Anti-Kickback Statute (AKS) with HealthValue Group Managing Partner Chris David. Hear why we need to be human to make AI helpful, how to protect your nonproprietary data AI canât replicate, why survey data & valuation models are a commodity now, why AI wonât replace you as healthcare consultants, and an exercise involving a letter generated by Copilot. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Artificial Intelligence (AI) can save a lot of time, but you need to use it wisely. In Part 1 of this 2-part episode, Captain Integrity Bob Wade talks the intersection of AI, Fair Market Value (FMV), the Stark Law, and the Anti-Kickback Statute (AKS) with HealthValue Group Managing Partner Chris David. Hear how AI is already impacting the healthcare consulting industry, notable cases involving AI, the top use cases for AI tools, how AI-generated documents are viewed under the Stark Law, and whether the government is accepting AI. Learn more at CaptainIntegrity.com
-
Send us Fan Mail
Federally Qualified Health Centers (FQHCs) serve a medically underserved population. In this episode, Captain Integrity Bob Wade talks FQHCs, the Anti-Kickback Statute (AKS), and the Stark Law. Hear whether the Stark Law applies to FQHCs, the wide range of financial arrangements that can happen, why itâs important to document those financial arrangements, the most important rules & provisions to follow, and the history of the âpulling togetherâ phrase. Learn more at CaptainIntegrity.com
- Show more
