A federal judge ruled an antitrust suit, filed by former employees of Deerfield, Ill.-based SCA Health, can move forward against Dallas-based Tenet Healthcare, DaVita and UnitedHealth Group affiliates, Bloomberg Law reported Sept. 27. 

UnitedHealth Group is the insurer with the largest market share, according to a September report from ValuePenguin. 

Pharmaceutical company Biogen has agreed to pay $900 million to resolve allegations it paid kickbacks to physicians to prescribe Biogen drugs, the U.S. Justice Department said Sept. 26. 

While many procedures are migrating to the ASC setting, "historically" slow payer policy changes could create delays, according to administrator Brenda Carter. 

CMS reduced outpatient overpayments given for patients receiving inpatient services in other facilities by updating their system, according to an audit from the HHS Office of Inspector General. 

High patient deductibles are shifting the way physicians deliver care, according to Eric Anderson, MD, a pain management physician in Lewisville, Texas.

Hospitals and health systems need to update their physician compensation plans after CMS' recent changes to the Stark Law, according to an article in JDSupra from the law firm Foley and Lardner. 

The Ambulatory Surgery Center Association submitted comments to CMS on the Medicare 2023 proposed payment rule Sept. 13, asking the organization to make updates that would benefit ASCs as "high-quality, lower-cost facilities for outpatient surgical care," the company said in the letter shared with Becker's. 

From high-acuity spine to cardiac procedures, five ASC leaders joined Becker's to share what procedures they see moving to the ASC setting.

Aetna, a CVS Health company, insures about 39 million people.

From the canceling of nearly $2 billion in projects to a terminated contract with Tenet, here are nine Centene updates published by Becker's since Aug. 1.

Former NBA player Terrence Williams, the 11th overall pick in the 2009 NBA draft, pleaded guilty to healthcare and wire fraud conspiracy charges and aggravated identity theft, the Justice Department said Aug. 26.

Taylor Theunissen, MD, and Metairie, La.-based Sadeghi Center for Plastic Surgery filed a lawsuit against UnitedHealthcare, alleging the insurer failed to pay preathorized claims in violation of the Employee Retirement Income Security Act, according to Law Street Media.

The HHS and Labor Department Aug. 19 issued the final rules for the No Surprises Act.

Optical devicemaker Essilor is paying $16.4 million to settle allegations that it paid kickbacks and violated the False Claims Act, the Justice Department said Aug. 23.

The trend toward value-based care models in recent years has been followed by a push for quality performance metrics.

The Medical Group Management Association recently released its report, "Patient Access and Value-based Outcomes Amid the Great Attrition," which details the revenue driven from value-based contracts in healthcare by specialty.  

Negotiating contracts with commercial payers is one of the most challenging and fatiguing aspects of an ASC administrator's role. But there are core strategies administrators should consider when sitting at the table with insurers, including arming oneself with cost and outcomes data, understanding the market and fostering good relationships with negotiators.

Payers UnitedHealth, Anthem and Cigna are some of the largest insurers by membership. 

Healthcare providers have been pushing for prior authorization reform this year, and many states are passing legislation to remove prior authorization requirements.