• The danger of the ASC reimbursement declines

    ASCs are struggling to meet margins as procedures continue to migrate to the outpatient setting but reimbursements stagnate. 
  • 3 states move to restrict noncompetes amid the FTCs' looming ban

    The Federal Trade Commission voted 3-2 on April 23 to ban on noncompete clauses for most U.S. workers, and several states have since made moves to restrict noncompetes at the state level. 
  • Texas physician convicted in $70M Medicare scheme

    A Texas physician was convicted by a federal jury for his involvement in the submission of more than $70 million in fraudulent claims to Medicare for unnecessary orthopedic braces and tests.
  • Nevada physician convicted of $2M fraud scheme

    A Nevada physician was convicted for his role in defrauding Medicare and Medicaid of nearly $2 million.
  • Michigan physician convicted in $6.3M Medicare fraud scheme

    A physician from Bloomfield Hills, Mich., was convicted of healthcare fraud and making false statements in what federal officials say was a $6.3 million Medicare fraud scheme.
  • The Medicare policies restricting ASC growth

    Three ASC leaders joined Becker's to discuss the Medicare policies that are impeding the growth of surgery centers. 
  • ASC reimbursements are changing – here's how 

    The ASC sector has seen continued increases in CMS payment rates as procedures continue to shift to the outpatient setting, according to VMG Health's 2024 Healthcare M&A Report published May 7.
  • The Value of an Offensive and Defensive RCM Game Plan: Orthopedic ASCs Score Big Wins with Prior Authorization Strategies

    Prior authorizations stand as both a gatekeeper and a stumbling block for the ASC industry. These pre-approvals required by payers serve as a crucial step in ensuring the medical necessity of procedures while functioning as a cost-control mechanism. However, the journey from authorization request to approval is often challenging, particularly for orthopedic procedures.
  • How the cost of 4 ASC procedures has changed

    Here is how the cost of four common ASC procedures has changed from 2019 to 2024, using data from  Blue Cross Blue Shield affiliate Blue Health Intelligence's "Rising Prices for Hospital Outpatient Care" brief, published last year and Sidecar Health's care calculator:
  • Are nonprofits exempt from FTCs' noncompete ban?

    The Federal Trade Commission voted to ban noncompete clauses for most U.S. workers April 23. The rule would make it illegal to include noncompetes in employment contracts unless the employer is a nonprofit, as the FTC's jurisdiction does not generally cover tax-exempt organizations, according to an article by law firm Sheppard, Mullin, Richter & Hampton published April 30 in National Law Review. 
  • The battle against the FTC noncompete ban heats up

    The Federal Trade Commission voted to ban noncompete clauses for most U.S. workers April 23, and organizations have begun to file lawsuits. 
  • Maryland bans noncompetes for healthcare employees amid FTC decision

    Maryland Gov. Wes Moore has signed a law prohibiting noncompetes for healthcare professionals April 25, according to an article by labor law firm Littler published in JDSupra. 
  • Physician reimbursements down 2.3%

    Physician reimbursement amounts per Medicare patient decreased around 2.3% between 2005 and 2021 when accounting for inflation, according to a new study from the Harvey L. Neiman Health Policy Institute.
  • New Jersey physician convicted for $5.4M Medicare fraud scheme

    A physician from Sewell, N.J., was convicted for causing the submission of more than $5.4 million in fraudulent claims to Medicare.
  • 6 CMS wins, losses for ASCs in 2024

    Here are six recent moves by CMS that may benefit — or burden — ASCs, as reported by Becker's in 2024: 
  • ASCs' reimbursement problem 

    ASCs are historically reimbursed at lower levels than hospital outpatient departments, despite being considered by many in healthcare to be a high-quality and low-cost site of care. 
  • FTC to ban noncompetes 

    The Federal Trade Commission has banned noncompete clauses for most U.S. workers, The Washington Post reported April 23. 
  • Where physician noncompetes could be banned next

    The Pennsylvania House has passed legislation that would ban noncompete clauses for  physicians, certified registered nurse practitioners and physician assistants.
  • FTC to vote on noncompete ban 

    The Federal Trade Commission will hold an open meeting to vote on its proposed noncompete ban April 23.
  • Streamlining Prior Authorizations: Balancing AI, Automation, and Human Expertise

    The manual prior authorization process stands as a notorious drain on both time and money. For ASCs, this aspect of the revenue cycle curtails efficiency but also strains staff resources, jeopardizing cash flow and overall financial success.

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