Author's posts
Court upholds record-breaking $40M verdict against physician
The Georgia Court of Appeals has upheld a $40 million judgment against emergency room physician Matthew Womack, MD, marking what is believed to be the largest emergency room malpractice verdict in the state’s history, according to a March 20 news release from Bell Law Firm. What happened? Who else is involved?
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Surgical hospital sues Cigna for $1.34M in claims
Lenexa, Mo.-based Minimally Invasive Surgery Hospital has filed a lawsuit against Cigna, alleging the insurer failed to pay $1.34 million in claims, Kansas City Business Journal reported March 27. . What happened? Becker’s has reached out to Cigna and will update this story if more information becomes available.
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Which ASC specialty has the highest case revenue?
Orthopedic procedures had the highest average net revenue per case at ASCs in 2024, according to HST Pathways’ latest “State of the Industry Report.” Here is a breakdown of the average net revenue per case by specialty:
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ASC prior authorizations continue to rise
Prior authorization rates are increasing at ASCs, according to HST Pathways’ latest “State of the Industry Report.” The report surveyed 590 ASCs in 47 states. Here are five more insights to know: 1. In 2024, 46% of cases completed preauthorizations, up from 42% in 2023. 2. Only 24% of cases that required a preauthorization in […]
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Physician among those indicted in $8M fraud scheme
A federal jury has convicted a Kentucky physician, among other parties, for his role in a scheme to defraud Medicare and Kentucky Medicaid via Kentucky Addiction Centers, according to a March 26 news release from the Justice Department. What happened? What’s next?
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ASC cancellation rates tick up
ASCs are seeing a slight increase in case cancellations, averaging a 21% cancellation rate in 2024 — up from 20% in 2023, according to HST Pathways’ latest “State of the Industry Report.” Here are four more insights: 1. Seventy-seven percent of healthcare services using text messaging saw improved outcomes. 2. ASCs collected 51% of expected […]
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Gastroenterology volume, revenue up in ASCs
The average monthly gastroenterology case volume at ASCs in 2024 reached 176, up from 167 in 2023, according to HST Pathways’ latest “State of the Industry Report.“ The report surveyed 590 ASCs in 47 states. Here are five more key insights 1. At 59.6%, gastroenterology had the highest operating room block utilization among specialties in […]
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Anesthesia billing’s ‘hidden revenue killers’
Anesthesia billing is complicated and evolving, according to a March 15 blog post from Knack RCM. Here are nine of the “hidden revenue killers,” according to the report: 1. Time-based billing complexity Unlike most specialties, anesthesia billing is time-based. Payers differ in how they calculate time units — Medicare uses decimals, while some commercial plans […]
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Physician executive, medical group to pay $60M+ for false claims suit
A medical group, its subsidiary and its former physician president will pay more than $60 million for allegedly submitting false diagnosis codes to inflate Medicare Advantage payments, according to a March 26 news release from the Justice Department. What happened? Who else is involved?
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Physician pay by specialty
Radiology was the highest-paid physician specialty in 2023, according to MedPAC’s March 13 report to Congress. Here’s the median annual compensation for physicians by specialty in 2023:
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