Category: ASC Coding, Billing and Collections

Earlier this year, Congress reduced physician pay rates under Medicare Part B by 1.7%, following a 2% cut in physician reimbursements in 2023. 

Nearly half of physicians are in support of accepting more Medicare patients at their practice, according to Medscape’s 2024 “Medscape Doctors Evaluate Medicare and Medicaid Report 2024,” published July 12. 

As more procedures gain approval to be conducted on an outpatient basis, reimbursement differences between various care settings have gained significant attention in the healthcare industry — among patients, executives and clinicians alike. 

Cataract excision surgery with removal of lens, without endoscopic cyclophotocoagulation, was the most frequently conducted procedure at ASCs in 2023, according to an analysis by healthcare market intelligence company Definitive Healthcare.

The burden of prior authorization is growing as “payers seek new strategies to reduce outlays,” according to a June 24 blog post from Coronis Health. 

The federal government is targeting New York City-based Mount Sinai Health System’s inclusion of noncompete clauses in contracts for part-time physicians in a June 18 complaint filed with the National Labor Relations Board. 

The Federal Trade Commission’s ban on noncomepte clauses is facing a preliminary injunction from a federal court in Texas. 

Medicare Advantage plans have garnered animosity from providers due to the restrictive approval processes for needed services.

The Justice Department charged 193 people, including 76 physicians, for their alleged roles in fraud schemes nationwide.

CMS has updated its coverage requirements for ASCs, The Joint Commission said in a June 26 news release.