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Episode 168: Understanding the Basics of CMS’ Administrative Simplification Enforcement

Michael welcomes Paul Anderson (Health Insurance Specialist) and Jamie Lookabill (Technical Advisor, Enforcement Division) with the Centers for Medicare & Medicaid Services to offer an introductory look at the administrative simplification enforcement process. Paul and Jamie offer information on the different types of HIPAA enforcement, how CMS communicates with the industry about enforcement, and the overall enforcement process, from filing a complaint, the use of ASETT (Administrative Simplification Enforcement and Testing Tool), corrective action plans and civil monetary penalties.

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Episode 167: The Need for Collaboration & Investment to Evolve Healthcare Interoperability. Sponsored by InterSystems

This episode is sponsored by InterSystems, the leading provider of AI-enabled data management solutions for industries with complex challenges, including healthcare, financial services, and supply chain and logistics.

Michael welcomes Steven Berkow, Senior Advisor, Value-Based Care with InterSystems. The two discuss Steve’s involvement at WEDI’s Summer Forum in Chicago, where he served as a moderator for the payer panel on the CMS Interoperability and Prior Authorization Rule. The two discussed the challenges and potential solutions for improving interoperability within healthcare data, and the importance of standardizing APIs for healthcare providers.

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Episode 163: Being Curious About Artificial Intelligence with Google’s Shweta Maniar

Michael welcomes back Shweta Maniar, Global Director, Life Sciences Solutions and Strategy for Google Cloud. The two discuss the continued emergence of artificial intelligence in health care, the need for standards or a framework in health care regarding AI, and how people new to AI can brush off misconceptions and dive in feet first and learn how they can access and leverage this growing technology.

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Episode 162: Workgroup Voices, The Inner Workings of Prior Authorization

Michael welcomes 3 of the 4 co-chairs of WEDI’s Prior Authorization Subworkgroup:

Heather McComas, Director, Administrative Simplification Initiatives, American Medical Association
David Delano, Senior Director of Services, Massachusetts Health Data Consortium
Raj Godavarthi, Associate VP of Technology and Interoperability, MCG Health
The 3 discuss the changes in the workgroup and the industry since the January 2024 release of the CMS Interoperability and Prior Authorization rule, the exciting role of artificial intelligence in PA, and how their unique stakeholder roles offer a full, detailed dialogue during their monthly meetings.

Tons of Prior Authorization-related education coming to you courtesy of WEDI. Visit wedi.org and click CALENDAR for more information

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Ep 161: Simplifying Healthcare: WEDI’s Approach to Eligibility and Benefits.

Michael welcomes Donna Campbell (HCSC) and Amanda Abbott (BCBS of Kansas), WEDI’s Eligibility and Benefits Workgroup Co-Chairs. The co-chairs discuss the workgroup’s missions and the latest discussion topics that workgroup is undertaking, including improving efficiencies in the E&B process through standards and emerging technology.

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Ep 160: Top 10 Cybersecurity Tips for Health Care. A Chat with WEDI’s Privacy and Security Workgroup Co-Chairs

The threat from cyberattacks is growing exponentially and health care organizations are particularly vulnerable. Michael chats with WEDI’s Privacy and Security Workgroup Co-Chairs, Lesley Berkeyheiser of DirectTrust and Thanh-Thien Nguyen of Kaiser Permanente on suggested actions that health care organizations big and small can adopt, customize, and implement as they seek to establish good cyber hygiene.
The top 10 list will be available soon on wedi.org

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