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PODCAST

Compliance Deconstructed

Jessica Zeff, Lorie Davis, & Elvan Baker

Welcome to Compliance Deconstructed, a podcast dedicated to all things Healthcare Compliance.Hosted by Healthcare Compliance professionals Jessica Zeff, Lorie Davis, and Elvan Baker, each episode thoroughly breaks down the complex inner-workings of compliance in the healthcare industry.From the 7 Elements that make up Healthcare Compliance to AI"s impact on the industry and everything in between, Compliance Deconstructed is your resource for information, strategy, and commentary to elevate your

business medicine

All Episodes

42:49

United Healthcare's Shocking Billing Fraud Exposed:...

Compliance Deconstructed ·

2025/12/09

In this episode of Compliance Deconstructed, Jessica, Elvan, and Lorie break down the complex relationship between healthcare compliance, patient safety, and organizational integrity. They use a major real-world case study (United Healthcare, to be exact) to show how compliance failures ripple across quality of care, operations, and public trust.The hosts explore how organizational culture can make or break an effective compliance program, emphasizing the powerful influence of informal norms and

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44:03

Board Fiduciary Duties Explained - How to Avoid...

Compliance Deconstructed ·

2025/11/25

Compliance Deconstructed is back and in this episode, hosts Jessica Zeff, Lorie Davis, and Elvan Baker break down the fundamentals of fiduciary duties and why they matter for every organization. This in-depth conversation explores how strong oversight begins with understanding the core responsibilities every board member holds, showcasing how fiduciary duties serve as the backbone of organizational stewardship and how compliance programs empower boards to uphold those duties effectively.Jessica,

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45:29

Proven Strategies to Justify Your Compliance Budget

Compliance Deconstructed ·

2025/11/11

Compliance Deconstructed is back and, in this episode, Jessica Zeff, Elvan Baker, and Lorie Davis dive into why budgeting is essential for building a strong, sustainable compliance program. They challenge the common misconception that compliance is a low-cost, back-office function and outline why underfunding it puts organizations at risk.Throughout this episode you will gain insight into the true nature of compliance work, from developing policies to managing investigations and why these tasks

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41:31

The 2026 Medicare Final Rule --- Are You Ready?

Compliance Deconstructed ·

2025/10/28

In this all-new episode of Compliance Deconstructed, Jessica Zeff, Elvan Baker, and Lorie Davis unpack the major changes included in the latest Medicare Final Rule. From medication affordability to patient rights, the discussion centers on how these updates are poised to drive better health outcomes and increase clarity for healthcare providers and patients alike.One major highlight is the new $35 cap on insulin costs for Medicare beneficiaries, offering a more predictable and affordable path for

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48:56

How to Create a Bulletproof Compliance Plan - A...

Compliance Deconstructed ·

2025/10/14

Hosts Jessica Zeff, Lorie Davis, and Elvan Baker are back and, in this episode of Compliance Deconstructed, they break down the key elements of building an effective compliance work plan that truly supports organizational success. This is a deep dive that explores how a well-structured plan can shift compliance from a reactive process to a proactive, strategic advantage.A compliance work plan serves as your organization’s annual roadmap, outlining priorities, audits, and goals that guide your

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43:24

Compliance Culture: It's More Than Just Rules

Compliance Deconstructed ·

2025/09/30

Building a strong compliance culture requires more than just checking boxes. It demands a shift in mindset across the entire organization. In this informative episode of Compliance Deconstructed, hosts Jessica Zeff, Lorie Davis, and Elvan Baker break down the foundational principles that turn compliance from a burden into a powerful driver of trust, integrity, and long-term success.Compliance culture is more than a policy manual; it’s the framework that ensures ethical behavior, consistent

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38:48

One Big Beautiful Bill Act Explained: What You Need...

Compliance Deconstructed ·

2025/09/16

In this episode of Compliance Deconstructed, hosts Jessica Zeff, Lorie Davis, and Elvan Baker break down the complexities of the “Big Beautiful Bill” and its potential impact on healthcare. The conversation highlights both the bill’s stated goal of simplifying billing and the unintended consequences that could create new challenges for patients and professionals alike.For compliance professionals and healthcare leaders, understanding healthcare policy changes requires more than reading the

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71:39

No Hiding Behind the Company: Leaders Face Jail Time

Compliance Deconstructed ·

2025/09/02

Federal prosecutors aren't just fining companies anymore. They're putting leaders in the crosshairs. In this eye-opening episode of Compliance Deconstructed, hosts Jessica Zeff, Lorie Davis, and Elvan Baker unpack the Hertel & Brown case and why owners (not just businesses) are facing the consequences. Throughout this episode, they reveal how a network of billing scams, data manipulation, and oversight failures resulted in criminal charges for not only executives but also the

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53:27

RADV Audit Prep: Compliance Tips You Can't Ignore

Compliance Deconstructed ·

2025/08/19

In this episode of Compliance Deconstructed, hosts Jessica Zeff, Lorie Davis, and Elvan Baker take a deep dive into the world of Risk Adjustment Data Validation (RADV) audits. These audits have become an increasingly high-stakes area of focus for healthcare compliance professionals navigating today’s regulatory landscape and this conversation will help you understand them on a deeper level.Throughout this episode, your hosts cover the purpose and impact of RADV audits, including how CMS uses them to

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41:55

The Good, The Bad, and The Bot: AI’s Role in...

Compliance Deconstructed ·

2025/08/05

Jessica, Lorie, and Elvan (your favorite Compliance professionals) are back with another installment of Compliance Deconstructed and In this insightful episode, they explore the growing role of Artificial Intelligence (AI) in detecting and preventing healthcare fraud. With healthcare systems facing persistent issues of fraud, waste, and abuse, AI offers new tools to identify patterns, flag anomalies, and streamline compliance efforts.The discussion dives into how AI can both help and hinder fraud

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54:15

The United Healthcare Investigation - What It Means...

Compliance Deconstructed ·

2025/07/22

We’re back for Episode 5 of Compliance Deconstructed and today, Jessica Zeff, Lorie Davis, and Elvan Baker explore how recent fraud investigations and emergency response funding missteps impact healthcare compliance. They emphasize the importance of understanding fraud, waste, and abuse regulations to reduce risk and protect patient care quality. Throughout this conversation, the ladies discuss the Department of Justice’s investigation into United Healthcare for alleged upcoding practices to ...

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44:46

Is It Fraud, Waste, or Abuse? Know The Difference

Compliance Deconstructed ·

2025/07/08

In this insightful episode of Compliance Deconstructed, Jessica Zeff, Lorie Davis, and Elvan Baker break down the often-misunderstood concepts of fraud, waste, and abuse in the healthcare industry. With real-world examples and expert commentary, the team explores how these terms differ and why the distinctions matter for healthcare professionals and organizations alike. Throughout this conversation, you’ll gain clarity on what constitutes healthcare fraud, including how intent plays a central...

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26:49

Medicare Final Rule 2026 | AI, Weight Loss Drugs &...

Compliance Deconstructed ·

2025/07/01

It’s time for Episode 3 of Compliance Deconstructed and today, Jessica Zeff, Lorie Davis, and Elvan Baker break down the recent Medicare final rule updates effective January 1, 2026, focusing on what was left out, positive changes, and how compliance professionals can navigate the evolving regulatory environment. A key focus of discussion are the absence of clear AI guidelines, coverage decisions on anti-obesity medications, and prior authorization requirements continue to create challenges for

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66:32

Healthcare Compliance Deconstructed: Our Inaugural...

Compliance Deconstructed ·

2025/07/01

In the premiere episode of Compliance Deconstructed, your hosts Jessica Zeff, Lorie Davis, and Elvan Baker dive into the foundational principles that shape effective healthcare compliance programs. Whether you're a newcomer to the compliance world or a seasoned professional with years of experience under your belt, this episode offers a comprehensive, yet accessible overview to help you confidently navigate the regulatory landscape.The conversation is built around the Seven Elements of an

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37:03

AI & Compliance - Friend or Foe? Navigating the Risks...

Compliance Deconstructed ·

2025/07/01

It’s Episode 2 of Compliance Deconstructed and your favorite trio of Compliance professionals are back to take a closer look at how artificial intelligence (AI) is reshaping the landscape of healthcare compliance. With the ability to automate routine tasks, analyze vast data sets, and flag potential issues, AI offers exciting possibilities for improving both efficiency and effectiveness in compliance operations.But alongside these opportunities come critical risks and ethical considerations. From

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18:10

Introducing Compliance Deconstructed!

Compliance Deconstructed ·

2025/06/18

Welcome to Compliance Deconstructed, a podcast brought to you by Simply Compliance. Hosted by Jessica Zeff, Lorie Davis, and Elvan Baker, this podcast is set to break down and deconstruct many of the various complex aspects of Healthcare Compliance. From the 7 Elements to Medicare to AI's role in today's healthcare landscape and everything in between, you've discovered the best resource for elevating your knowledge in the healthcare compliance space.Whether you're new to the

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16 results

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