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More indirect pay arrangements scrutinized in proposed Stark update: 3 details
CMS aims to refine Stark Law regulations on indirect compensation arrangements for physician referrals to services performed by immediate family members. -
Payer behavior ASC execs see more of these days
Payer policies and strategies are evolving as more surgeries become approved in the outpatient setting. -
Front-end missteps can hurt an ASC's bottom line: 4 tips from National Medical Billing Services
An ASC's revenue and profits are directly linked to its front-end processes. -
Illinois ASC, BCBS of Illinois don't renew contract; 100,000 patients affected
Springfield (Ill.) Clinic and Blue Cross Blue Shield of Illinois have not been able to negotiate an extension of their in-network contract for PPO health plan members, which means 100,000 patients will be considered out-of-network for its ASC as of Aug. 19. -
National Spine & Pain Center to pay $5.1M billing fraud settlement: 5 details
A Rockville, Md.-based spine and pain center chain will pay millions to resolve Medicare fraud claims. -
Aetna in the past 30 days: 7 updates
Aetna, a CVS Health company, is one of the largest insurers, serving roughly 39 million people nationwide. -
Future of payer market hinges on 'political fallout,' 1 administrator says
Lakeside Orthopedic Institute in Lake Havasu City, Ariz., uses ability and growth to leverage payer contracts. -
Why Surgery Partners' CEO isn't worried about CMS policy updates
Eric Evans, CEO of Brentwood, Tenn.-based Surgery Partners, addressed investor questions about how the CMS 2022 proposed payment rule would affect its ASC business. -
Surgical Notes acquires ASC revenue cycle management provider
Surgical Notes has acquired Zulu Health, an ASC-focused revenue cycle management provider, Surgical Notes said Aug. 3. -
ASCs may get extra pay bump from CMS next year for 440 surgeries
While CMS proposed removing 258 recently added procedures from the ASC-payable list in its 2022 proposed payment rule, another policy change would add some procedures and improve payment for hundreds of others in the outpatient setting. -
Fallout of the CMS 2022 pay proposal for ASCs: 3 notes
If finalized, the proposed CMS 2022 Hospital Outpatient Payment Prospective System and ASC Payment System rule may have lasting ramifications for ASCs and the healthcare system. -
ASC loses bid to recover $5.6M from Cigna for now
An Arizona ASC will have to revamp its complaint against Cigna to recover $5.6 million by next month, or it will be dismissed entirely. -
ASC leaders on the future of the payer market
ASCs have long struggled to secure reimbursements — with CMS' proposal to remove 258 procedures from the ASC payable list, leaders are concerned that securing payment could become even more challenging. -
How the payer market could change in the next 5 years
Mark Reinford predicts consolidation amongst big payers and consolidation in fee schedules in the payer market in the next five years. -
Third-party administrators can help leverage contracts, one ASC leader says
ASCs often can struggle to leverage payer contracts in comparison to larger hospitals and health systems. -
How direct contracting with ASCs can benefit employers
ASCs can often offer higher-quality care at lower rates, making it a prime location for direct contracting. -
The 258 procedures CMS plans to cut from the ASC payable list
The proposed 2022 Hospital Outpatient Prospective Payment System and ASC Payment System would remove 258 procedures from the ASC payable list if finalized later this year. -
CMS aims to reinstate the inpatient only list, boost ASC pay 2.3% in 2022
CMS issued the 2022 Hospital Outpatient Prospective Payment System and ASC Payment System proposed rule July 19, which includes some big updates for ASCs. -
CMS may stop paying for 258 procedures in ASCs
CMS proposed reversing some of the policy changes ASC executives celebrated last year. -
Implant costs vs. ASCs: How 1 management company leverages payer contracts
As higher-acuity procedures move outpatient, independent ASCs could have difficulty securing reimbursements.
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