Host Jonathan Porter welcomes Sean Weiss from DoctorsManagement, LLC to the podcast to discuss the rapidly evolving healthcare compliance landscape. With healthcare representing 83% of False Claims Act settlement and judgment dollars last year, Sean shares insights on how AI, telehealth, and changing enforcement tactics are reshaping compliance risks for providers.
Host Jonathan Porter welcomes Sean Weiss from DoctorsManagement, LLC to the podcast to discuss the rapidly evolving healthcare compliance landscape. With healthcare representing 83% of False Claims Act settlement and judgment dollars last year, Sean shares insights on how AI, telehealth, and changing enforcement tactics are reshaping compliance risks for providers.
We begin by examining AI documentation and ambient scribes, now ubiquitous in healthcare. Sean discusses the risks of cloning and clinical plagiarism, explaining what makes notes “audit bait” and how providers can maintain documentation integrity. He also shares recent state-level enforcement actions against AI scribe companies.
Next, we turn to telehealth integration. Moving beyond “telefraud” schemes, Sean provides best practices for legitimate providers looking to safely incorporate telehealth into their practices without stepping on compliance landmines.
Our conversation shifts to modifier 25, a favorite target of auditors and enforcers. Drawing on Jonathan’s DOJ experience using outlier data to identify potential targets, Sean explains what makes modifier 25 usage defensible and shares best practices for ensuring documentation supports billing practices.
We close with Sean’s expert prognostication on where healthcare compliance and enforcement are heading over the next five years, and his prediction that False Claims Act recoveries will explode in the near future due to increased technological capabilities by enforcers.
Jonathan Porter | Full Biography
Jonathan focuses on white collar criminal defense, federal investigations brought under the False Claims Act, and litigation against the government and whistleblowers. He draws on his experience as a former federal prosecutor to guide clients in sensitive and enterprise-threatening litigation. At the Department of Justice, Jonathan earned a reputation as a top white-collar prosecutor and trial lawyer and was a key member of multiple international healthcare fraud takedowns and high-profile financial crime prosecution teams. He serves as a vice chair of the American Health Law Association’s Fraud and Abuse Practice Group and teaches white collar crime as an adjunct professor of law at Mercer University School of Law.
Sean Weiss | Full Biography
Sean is Partner & VP of Strategic Litigation Support and Regulatory Affairs at DoctorsManagement, LLC. He has devoted more than 30 years to advising and advocating for healthcare providers, hospital networks, and integrated health systems, helping organizations strengthen financial performance while reducing regulatory exposure. His command of state and federal governmental processes, underscored by his appointment by the U.S. Department of Health and Human Services to the Board of Scientific Counselors for the National Committee on Vital and Health Statistics at the Centers for Disease Control and Prevention, has made him a trusted advisor to organizations facing complex reimbursement, compliance, and enforcement challenges. At DoctorsManagement, Sean leads the firm’s strategic litigation support, regulatory affairs, and audit functions. He is frequently retained by prominent national law firms, the Department of Justice, United States Attorney’s General, and Public Defenders in high stakes matters involving the False Claims Act, healthcare fraud enforcement, and other significant government investigations. In addition, he serves as an independent Compliance Officer for numerous nationally recognized organizations, helping leadership teams build practical, durable, and defensible compliance programs.