• Physician charged in $20.7M kickback scheme

    A New York City physician was charged for allegedly engaging in a $20.7 million healthcare fraud and illegal kickback scheme.
  • ASCs' reimbursement conundrum

    Low reimbursement rates continue to plague ASCs nationwide.
  • Arizona court rules in favor of noncompete: 5 things to know

    An Arizona federal court recently granted a franchisor company's motion to temporarily restrain a former franchisee from operating a competing business in a noncompete lawsuit, law firm Lathrop GPM wrote in a Feb. 19 article published by JDSupra.  
  • ASCs are catching the eye of Medicare

    The number of Medicare-certified ASCs has increased by 870 since 2011, according to a Feb. 13 report from financial advisory firm VMG Health. 
  • Stark law violators facing massive penalties 

    Some of the largest recoveries by the Justice Department in the last year were Stark law violations, according to a Feb. 8 report from law firm Mintz, which could mean the law could be enforced more strictly moving forward.
  • Medicaid disenrollments pass 16 million

    At least 16,430,000 Medicaid enrollees have been disenrolled as of Feb. 1, according to data from KFF.
  • Another state moves to restrict noncompetes 

    Legislation further amending noncompete policy in Washington has passed the state's Senate. 
  • From Denial to Approval: Winning More Prior Authorizations Starts with Tech-Driven Strategies

    Preauthorization. Precertification. Prior authorization. One of the most time-consuming, costly, and complex paperchase processes for the healthcare industry goes by many names.
  • Fee-for-service model still reigns supreme

    Forty-six percent of physicians participate in the fee-for-service payment model, according to Medscape's "Physician Compensation Report 2023."
  • Who's participating in value-based care?

    Despite its growing popularity, only 14% of physicians participate in the value-based payment model, according to Medscape's "Physician Compensation Report 2023."
  • Reimbursements for 11 new ASC-payable procedures

    CMS recently added 11 surgical codes to the ASC payable list and finalized a 3.1% payment rate for ASCs in its 2024 final rule.
  • The states with no certificate-of-need laws 

    Sixteen states have no certificate-of-need laws, according to a report from HealthCare Appraisers, a consulting firm. 
  • Noncompetes enforced in Delaware court decision 

    The Delaware Supreme Court ruled that financial services company Cantor Fitzgerald properly denied $9 million to former partners under noncompete agreements, Bloomberg Law reported Jan. 29. 
  • The push to change certificate-of-need laws

    More states have been looking to repeal or reform their certificate-of-need laws with the intention of increasing access to care. 
  • Tennessee couple sentenced in $65M healthcare fraud scheme

    A married couple living in Birchwood, Tenn., have been sentenced for a $65 million TriCare fraud scheme. 
  • 3 payer splits, resolutions affecting ASCs

    Becker's has reported on three major payer contract splits and resolutions that have affected ASCs since Dec. 5:
  • Surgeon's lawsuit over North Carolina's certificate-of-need policy: Where it stands

    The North Carolina Supreme Court has granted review in September for a lawsuit from Jay Singleton, MD, who owns an ophthalmology practice in New Bern, N.C., challenging the state's certificate-of-need laws. 
  • Bad news for FTC's noncompete ban

    The Federal Trade Commission has been largely silent on its proposed ban on noncompete contracts for full-time employees and independent contractors introduced January 2023, according to an article by law firm BakerHostetler published in JDSupra.
  • What a $345M Stark law ruling means for physician pay structure 

    Indianapolis-based Community Health Network recently agreed to pay $345 million to resolve claims it violated the False Claims Act and Stark law, indicating the importance for providers to pay close attention to physician compensation arrangements, law firm Baker Donelson wrote in a Jan. 22 article published by JDSupra. 
  • What every physician should know about Stark law

    Many physicians have experienced challenges stemming from Stark law, which bans them from making referrals for Medicare-payable health services if the physician or immediate family member has a financial relationship with the entity. 

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