Category: ASC Coding, Billing and Collections

Johnson City, Tenn.-based State of Franklin Healthcare Associates has joined Farm Bureau Health Plans’ Medicare Advantage network, in a move that comes as several major health systems are shying away from Medicare Advantage partnerships. 

ASCs have long faced obstacles to reimbursements, and some leaders are finding increasing obstacles to securing necessary pay for procedures. 

The chief compliance officer of a pharmacy holding company was sentenced to four years and six months in prison and must pay $21.7 million in restitution for his role in a healthcare fraud scheme. 

An often-overlooked part of running a practice is how to handle billing and collections. Having a partnership with a collections agency is something practices should consider, according to a Nov. 6 post by Anesthesia Business Consultants on its website.

Two pharmacy owners and a physician have been convicted for their role in a healthcare fraud, money laundering and tax evasion scheme. 

Here are five numbers about certificate-of-need laws that ASC leaders should know:

U.S. Senators Bill Cassidy, MD, Catherine Cortez Mastro, Elizabeth Warren and Marsha Blackburn have introduced bipartisan legislation to improve the transparency of Medicare Advantage plans. 

The Federal Trade Commission proposed a rule in January that would keep employees free from noncompete agreements nationwide. 

Insurance giant UnitedHealth Group is facing a lawsuit alleging it used an artificial intelligence algorithm to wrongfully deny coverage to older patients for care under its Medicare Advantage health policies, Bloomberg Law reported Nov. 14.

A 2023 report from insurer Humana shows that Medicare Advantage patients receiving care through value-based arrangements spend more time with their physicians and have better care outcomes than their non-value-based counterparts.