Latest / Off the Chart: A Business of Medicine Podcast
S1 Ep137: The war on health care fraud, with Shannon Sumner, CPA, CHC, of PYA
Health care fraud enforcement recovered more than $6 billion last year. Shannon Sumner, CPA, CHC, expects this year to be even larger.
In this episode, Sumner, managing principal of PYA's Nashville office and the firm's chief compliance officer, explains how enforcement has shifted from targeting large health systems to going after individual physicians and practice leaders. She walks through the highest-risk areas regulators are focused on in 2026, including billing and coding integrity, value-based care arrangements, telehealth documentation and artificial intelligence (AI)-assisted tools…
The skinny
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