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Insurers now required to cover follow-up colonoscopies
Surprise bills for colonoscopies following a stool-based screening test with positive results are now prohibited, according to Health Day. -
Oscar Health introduces tool letting patients compare costs between ASCs, hospitals
New York City-based insurance company Oscar Health introduced a price transparency tool that allows members to compare specific expenses for procedures at ASCs, hospitals and other settings. -
Iowa surgical group pays $612K to resolve fraud allegations: 5 details
Tri-State Specialists in Sioux City, Iowa, will pay hundreds of thousands of dollars to resolve billing fraud allegations. -
Cigna in the headlines: 5 updates in the last 30 days
Cigna is one of the oldest and largest payers in the U.S. with 20.4 million members. -
ASC disputes payer's conclusion that spine cases should have been in the hospital
The Center for Pain Management remains out of network with Blue Cross and Blue Shield of Minnesota after the payer terminated its contract over safety concerns in October. -
National Medical Billing Services buys mdStrategies
ASC revenue cycle management company National Medical Billing Services acquired mdStrategies, a medical coding company focused on ASCs. -
Aetna in the headlines: 7 updates in the last 90 days
Aetna is one of the country's largest health insurers, with 22.1 million members. -
Top-paid balloon sinuplasty physician indicted in fraud scheme: 3 details
Anita Louise Jackson, MD, was indicted Jan. 5 for allegedly spearheading a multimillion-dollar fraud scheme. -
UnitedHealthcare in the headlines: 4 recent stories
UnitedHealthcare is the largest health insurance company by membership with 70 million members. -
New Indiana law aims to reduce surprise billing
An Indiana law going into effect Jan. 1 hopes to reduce surprise billing, WNDU reported Dec. 28. -
California ASC will accept Bitcoin starting in January
Beverly Hills, Calif.-based Center for Advanced Facial Plastic Surgery will accept cryptocurrencies including Bitcoin starting in January, the center said Dec. 20. -
ASC, physician-owned hospital whistleblowers got up to $3M this year: 5 cases
Whistleblowers stand to receive a portion of the proceeds from a settlement or financial recovery, which can be hundreds of thousands or even millions of dollars. -
Ex-physician, ASC company found guilty of $355M fraud scheme
A federal jury on Dec. 16 found a former physician and his company guilty of a scheme to defraud private insurers and the Tricare program by submitting about $355 million in false claims. -
Surgeon to pay $3.7M to settle fraud claims, whistleblower gets 17%: 4 notes
The owner of two Montana-based vascular surgery centers agreed to pay millions to resolve allegations that he performed and billed for medically unnecessary procedures. -
'Seize the opportunity to market yourself' with price transparency, ASC leaders told
In November, CMS updated hospital price transparency regulation for hospitals with more than 30 beds. -
Mississippi physician to pay $375K to resolve Medicare billing fraud allegations
A Mississippi physician and his practice have agreed to pay $375,000 to resolve allegations of improperly billing Medicare in violation of the False Claims Act, the U.S. Attorney’s Office for the Southern District of Mississippi said Dec. 13. -
Physician, devicemaker to pay $4.2M to resolve kickback claims: 5 details
The owner of an Atlanta-based medical group and his practice will pay millions to resolve kickback allegations brought by a former employed physician, according to a Dec. 8 Justice Department statement. -
Up to 77% of physicians have difficulty advising patients on out-of-pocket costs: 5 findings
Most physicians have difficulty estimating out-of-pocket medication expenses even when they have access to patients' drug and insurance information, according to a study published in November in JAMA Network Open. -
Self-referral whistleblower on physician-owned hospital to receive $3M
A partially physician-owned hospital in Flower Mound, Texas, will pay millions to resolve allegations that it violated Stark Law, and the physician partner who blew the whistle will receive $3 million, according to a Dec. 2 Justice Department news release. -
Anesthesiologists accuse BCBS of North Carolina of using 'strong-arm tactics' & 6 more BCBS updates
The American Society of Anesthesiologists condemned BlueCross BlueShield of North Carolina's alleged abuse of the No Surprises Act to coerce clinicians and practices into network agreements in a Nov. 22 statement shared with Becker's.
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