Compliance Deconstructed

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 role in determining fraudulent behavior. The discussion covers deceptive practices like billing for unprovided services, upcoding, and illegal kickbacks, all of which carry serious compliance implications.

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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 effective compliance program - core building blocks that support ethical behavior and regulatory adherence. Each element plays a critical role in establishing a strong compliance...

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 algorithmic transparency to potential bias in sensitive areas like compliance hotlines, the introduction of AI raises important questions around trust, accountability, and the need for ongoing hu...

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 healthcare organizations.

The conversation also highlights some encouraging developments, including the elimination of cost sharing for adult vaccines, caps on insulin costs, and expanded acc...

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 industry or a seasoned professional, you'll find useful information to help you better understand what's happening at many levels of healthcare c...