Sponsored by nimble solutions | Contact us
-
Tennessee system joins Farm Bureau Health Plans' Medicare Advantage network as others bail
Johnson City, Tenn.-based State of Franklin Healthcare Associates has joined Farm Bureau Health Plans' Medicare Advantage network, in a move that comes as several major health systems are shying away from Medicare Advantage partnerships. -
'I have zero faith in our payers': Where ASCs are losing money with reimbursements
ASCs have long faced obstacles to reimbursements, and some leaders are finding increasing obstacles to securing necessary pay for procedures. -
Healthcare exec convicted for $50M Medicare fraud scheme
The chief compliance officer of a pharmacy holding company was sentenced to four years and six months in prison and must pay $21.7 million in restitution for his role in a healthcare fraud scheme. -
The benefits of partnering with collections agencies, per 1 group
An often-overlooked part of running a practice is how to handle billing and collections. Having a partnership with a collections agency is something practices should consider, according to a Nov. 6 post by Anesthesia Business Consultants on its website. -
Physician convicted in $145M fraud scheme
Two pharmacy owners and a physician have been convicted for their role in a healthcare fraud, money laundering and tax evasion scheme. -
Certificate-of-need laws by the numbers
Here are five numbers about certificate-of-need laws that ASC leaders should know: -
4 senators introduce legislation to improve Medicare Advantage transparency
U.S. Senators Bill Cassidy, MD, Catherine Cortez Mastro, Elizabeth Warren and Marsha Blackburn have introduced bipartisan legislation to improve the transparency of Medicare Advantage plans. -
Which states are targeting noncompetes?
The Federal Trade Commission proposed a rule in January that would keep employees free from noncompete agreements nationwide. -
Lawsuit alleges UnitedHealth used AI to wrongfully deny claims
Insurance giant UnitedHealth Group is facing a lawsuit alleging it used an artificial intelligence algorithm to wrongfully deny coverage to older patients for care under its Medicare Advantage health policies, Bloomberg Law reported Nov. 14. -
Value-based care lowers costs, improves patient outcomes: Report
A 2023 report from insurer Humana shows that Medicare Advantage patients receiving care through value-based arrangements spend more time with their physicians and have better care outcomes than their non-value-based counterparts. -
Justice Department files motion to dismiss SCA Health antitrust case
The Justice Department filed to dismiss the government's indictment against Deerfield, Ill.-based ASC chain SCA Health, formerly Surgical Care Affiliates, for allegedly agreeing with competitors to not poach senior-level employees. -
59 procedures added to ASC payable list in last 5 years
The CMS ASC payable list has seen sizable change in the last five years — through both additions and removals. -
HHS inspector general's latest anitkickback ruling: What ASCs need to know
HHS' Office of Inspector General has issued an advisory opinion on a new safe harbor to kickback laws that aims to increase quality while reducing costs, according to a Nov. 14 article in JDSupra from law firm WilmerHale. -
What to know about Stark law & physician referrals
HHS' Office of Inspector General released its General Compliance Program Guidance on Nov. 6, providing an overview on Stark law and physician referrals. -
The burden of prior authorizations: 5 key stats
Eighty-nine percent of providers said that prior authorizations were very or extremely burdensome, according to the Medical Group Management Association's 2023 "Regulatory Burden Report." -
Physicians and Stark law: 5 leaders' thoughts
Stark law settled a record-breaking $9.2 million in voluntary self-referral disclosure settlements in 2022, and many physician leaders have experienced obstacles stemming from Stark law policy. -
Prior authorization delaying 97% of providers' necessary care
Ninety-seven percent of providers' patients have received delays or denials for necessary care due to prior authorization requirements, according to the Medical Group Management Association's 2023 "Regulatory Burden Report." -
Geisinger joins Capital Blue Cross Medicare Advantage network
Danville, Pa.-based Geisinger has been added to Capital Blue Cross' Medicare Advantage network, beginning Jan. 1, according to a Nov. 9 report from The Valley Ledger. -
Number of Medicare Advantage plan offerings remains stagnant as systems cut ties
The average Medicare Advantage beneficiary can choose from a total of 43 plans for the 2024 enrollment period, the same number of plan options as 2023, according to data from KFF published Nov. 8. -
UnitedHealthcare providers by state
California has the largest number of providers accepting UnitedHealthcare insurance plans statewide, in addition to having more ASCs than any other state, according to the most recent data from the payer's website.
Page 6 of 93