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Payers recognizing the power of ASCs is 'crucial'
Josh Troast, director of ambulatory surgical services for Muskegon (Mich.) Surgical Associates, joined Becker's to discuss what ASCs need to thrive in the next five years. -
18 million-member health plan reforming prior authorization process
Health Care Service Corp., a health plan operator for 18 million members across Illinois, Montana, New Mexico, Oklahoma and Texas, is integrating artificial intelligence and augmented intelligence to reform its prior authorization process. -
The 'glaringly inappropriate' ASC reimbursement policy
CMS pitched a 2.8 percent average rate increase for ASCs next year, and many leaders feel the move isn't enough to offset increasing costs. -
'Will the last to leave please turn out the lights?': The consequences of declining physician pay
Physician pay is struggling to keep up with inflation, declining reimbursement and Medicare pay cuts. -
Why CMS' 2.8% ASC rate increase is 'very disappointing' and 'not enough'
In the 2024 hospital outpatient prospective payment system, CMS pitched a 2.8 percent average rate increase for ASCs next year. -
CMS' plan to add only dental procedures to ASCs a 'missed chance'
CMS plans to add only 26 dental surgical codes to the ASC payable list next year, according to the 2024 Hospital Outpatient Prospective Payment System proposal released July 13. -
16 physician kickback suits totaling $180M+ in 2023
Here are 16 physician kickback suits Becker's has reported on in 2023 that totaled more than $180 million in either restitution or cost of the fraud scheme: -
'This is a slap in the face to physicians': Reactions to CMS' pay cut proposal
Physicians and patients alike may face challenges due to CMS' suggested 3.34 percent conversion factor decrease from its proposed Medicare physician fee schedule for 2024. -
2 Florida men plead guilty to $67M Medicare fraud scheme
Two Florida men have pleaded guilty for their roles in a Medicare fraud scheme in which they submitted more than $67 million in false claims for unnecessary genetic testing and durable medical equipment that were procured with kickbacks. -
UnitedHealth's ASC strategy: 4 earnings call notes
UnitedHealth's new site-of-service policy is in part driven by the cost savings incurred by ASCs, executives said in a July 14 second-quarter earnings call transcribed by Seeking Alpha. -
'Our healthcare system is a travesty': Physicians fed up with CMS' proposed pay cuts
CMS suggested a 3.34 percent conversion factor decrease in its proposed Medicare physician fee schedule for 2024, which was released July 13. -
CMS doesn't plan to add new non-dental procedures to ASCs next year
The 2024 Hospital Outpatient Prospective Payment System proposal released July 13 would only add 26 dental surgical codes to the ASC payable list next year. -
3 major proposals from CMS that could shape the industry
Here are three pitches from CMS that Becker's has reported on since July 10 that could change the healthcare industry: -
CMS floats 3.34% physician pay cut
CMS is floating a 3.34 percent conversion factor decrease in its proposed Medicare physician fee schedule for 2024 released July 13. -
ASCs get 2.8% pay bump in CMS' 2024 proposal: 5 details
CMS pitched a 2.8 percent average rate increase for ASCs next year in the 2024 hospital outpatient prospective payment system, released July 13. -
California physician, practice to pay $11.4M fraud settlement: 5 details
Sacramento, Calif.-based Lags Spine & Sports Center along with its owner and medical director will pay millions of dollars to resolve false claims allegations, according to a Justice Department news release. -
ASCs want higher reimbursements now: 5 leaders' thoughts
For many ASCs, cost pressures persist and payers haven't adjusted to reflect rising costs. -
Physician sues Indiana health system over noncompete contract
Pediatric intensivist David Lankford, DO, is suing Fort Wayne, Ind.-based Lutheran Health Network, his former employer, to get out of his noncompete agreement, Indiana Public Media reported July 10. -
3 Stark law updates changing the healthcare landscape
Here are three Stark law updates Becker's has reported on since June 6: -
Largest physician groups based on Medicare charges
HCA Florida Healthcare Physicians is the largest physician group based on the amount of its Medicare charges, which reach over $6 billion annually, according to June 2023 data sent to Becker's from Definitive Healthcare. Editor's note: Data comes from the CMS Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, refreshed once a year in June. Current data represents calendar year 2021, the latest period for which official data exists.
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