Category: ASC Coding, Billing and Collections

For many ASCs, navigating payer behavior and declining reimbursements is the biggest challenge in maintaining profits. 

Physicians and other healthcare providers should keep a sharp eye on potential Stark law allegations amid increasing federal scrutiny, law firm Arnold & Porter wrote in an April blog post. 

The Federal Trade Commission’s ban on noncompete clauses is facing a preliminary injunction from a federal judge, and that injunction could potentially only apply to the plaintiffs suing the FTC, National Law Review reported July 22.

As many as nine out of 10 physicians say that prior authorization has a negative effect on patient outcomes, according to AMA’s survey of about 1,000 physicians nationwide.

The Department of Justice is doubling down on Stark law enforcement, with an uptick in complaints-in-intervention and Stark-related settlements, law firm Arnold & Porter wrote in an April blog post. 

Palo Alto, Calif.-based oncology company Guardant Health will pay $913,933 to settle allegations it violated Stark Law. 

The Federal Trade Commission is investigating DaVita and Fresenius Medical Care, two of the country’s largest dialysis providers, over allegations their noncompete clauses illegally stifle smaller competitors, Politico reported July 13. 

Here are six updates on Medicare Advantage that have made headlines recently, as reported by Becker’s since June 25:

Reimbursement differences between hospital outpatient departments and ASCs are a longstanding point of contention among ASC professionals, with Medicare ASC payments increasing only marginally while Medicare hospital pay has seen comparatively signific…

Medicaid patient counts for self-employed and employed physicians were substantially lower than Medicare, according to Medscape’s 2024 “Doctors Evaluate Medicare and Medicaid Report 2024,” published July 12.