• 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. 
  • Prior authorization reform ball in states' court

    Recent prior authorization reforms by CMS are a significant step in the right direction but are not an all-encompassing solution, according to the American Medical Association.
  • 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. 
  • Which states have banned noncompetes?

    Earlier this year, New York Gov. Kathy Hochul vetoed a bill that would've banned noncompetes and added the state to a short list of those prohibiting noncompetes. 
  • The payer trends defining ASCs

    Two ASC leaders joined Becker's to discuss the payer trends that are affecting ASCs in the most significant ways at the moment. 
  • What ASCs can expect from CMS' latest prior authorization ruling

    CMS has finalized prior authorization and electronic health information policy updates that are expected to create approximately $15 billion in savings over the next 10 years. 
  • nimble solutions appoints CEO

    St. Louis-based nimble solutions, an ASC revenue cycle management company, named Kelley Blair CEO.
  • Bill aims to push price transparency to ASCs

    A bill that would strengthen healthcare price transparency at ASCs has been introduced in the Senate, according to a news release from Indiana Sen. Mike Braun. 
  • ASC suit accusing Elevance of $5.4M+ in unpaid claims revived 

    A circuit court has reinstated a suit from the Costa Mesa, Calif-based South Coast Specialty Surgery Center accusing Blue Cross of California, which does business as Anthem Blue Cross, of racking up more than $5.4 million in unpaid claims. 
  • The payer behavior physicians want changed

    Five physician leaders joined Becker's to discuss the payer behavior they'd like to see changed in 2024. 
  • 3 payer rules that took effect Jan. 1

    This year is shaping up to be a big one for major U.S. payers, with several new rules going into effect. 

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