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5 largest payers by revenue
UnitedHealth Group is the largest payer by 2021 revenue, according to a Sept. 1 report from ValuePenguin. -
Former New Jersey PA sentenced for role in $1M healthcare fraud scheme
Willingboro, N.J.-based former physician assistant Aaron Jones, 28, was sentenced to two years in prison for a scheme that defrauded payers millions of dollars, Press of Atlantic City reported Oct. 5. -
Arizona health system files $10M breach of contract suit against physician group
Community Health has filed a suit to recover nearly $10 million from Fresno, Ariz.-based physician group Santé Health System, The Sun reported Oct. 5. -
SCA Health, USPI antitrust suit moving forward, judge rules
A federal judge ruled an antitrust suit, filed by former employees of Deerfield, Ill.-based SCA Health, can move forward against Dallas-based Tenet Healthcare, DaVita and UnitedHealth Group affiliates, Bloomberg Law reported Sept. 27. -
Market share of the 10 largest payers
UnitedHealth Group is the insurer with the largest market share, according to a September report from ValuePenguin. -
Biogen pays $900M to settle physician kickback allegations
Pharmaceutical company Biogen has agreed to pay $900 million to resolve allegations it paid kickbacks to physicians to prescribe Biogen drugs, the U.S. Justice Department said Sept. 26. -
'Historically' slow payers hindering ASC procedure migration, admin says
While many procedures are migrating to the ASC setting, "historically" slow payer policy changes could create delays, according to administrator Brenda Carter. -
CMS changes reduced outpatient overpayments: OIG
CMS reduced outpatient overpayments given for patients receiving inpatient services in other facilities by updating their system, according to an audit from the HHS Office of Inspector General. -
High patient deductibles are disrupting the ASC industry, physician says
High patient deductibles are shifting the way physicians deliver care, according to Eric Anderson, MD, a pain management physician in Lewisville, Texas. -
Stark Law changes: Physician compensation arrangements to keep an eye on
Hospitals and health systems need to update their physician compensation plans after CMS' recent changes to the Stark Law, according to an article in JDSupra from the law firm Foley and Lardner. -
The 47 procedures ASCA wants CMS to add to the approved procedure list
The Ambulatory Surgery Center Association submitted comments to CMS on the Medicare 2023 proposed payment rule Sept. 13, asking the organization to make updates that would benefit ASCs as "high-quality, lower-cost facilities for outpatient surgical care," the company said in the letter shared with Becker's. -
What procedures are migrating to ASCs?
From high-acuity spine to cardiac procedures, five ASC leaders joined Becker's to share what procedures they see moving to the ASC setting. -
Aetna in the headlines: 7 updates in 30 days
Aetna, a CVS Health company, insures about 39 million people. -
Centene in the headlines: 9 updates in 30 days
From the canceling of nearly $2 billion in projects to a terminated contract with Tenet, here are nine Centene updates published by Becker's since Aug. 1. -
Former NBA player orchestrated $5M health insurance fraud
Former NBA player Terrence Williams, the 11th overall pick in the 2009 NBA draft, pleaded guilty to healthcare and wire fraud conspiracy charges and aggravated identity theft, the Justice Department said Aug. 26. -
ASC sues UnitedHealthcare for alleged ERISA violations
Taylor Theunissen, MD, and Metairie, La.-based Sadeghi Center for Plastic Surgery filed a lawsuit against UnitedHealthcare, alleging the insurer failed to pay preathorized claims in violation of the Employee Retirement Income Security Act, according to Law Street Media. -
No Surprises Act final rules: What ASCs need to know
The HHS and Labor Department Aug. 19 issued the final rules for the No Surprises Act. -
Optical devicemaker settles kickback allegations for $16.4M
Optical devicemaker Essilor is paying $16.4 million to settle allegations that it paid kickbacks and violated the False Claims Act, the Justice Department said Aug. 23. -
35% of physicians see increase in compensation tied to quality
The trend toward value-based care models in recent years has been followed by a push for quality performance metrics. -
Value-based contract revenue as percentage of total revenue in 3 categories
The Medical Group Management Association recently released its report, "Patient Access and Value-based Outcomes Amid the Great Attrition," which details the revenue driven from value-based contracts in healthcare by specialty.
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