CMS has proposed a new Medicare physician payment schedule for 2024, addressing topics from anesthesia conversion rates to merit-based payment systems.
Category: ASC Coding, Billing and Collections
5 largest health insurance companies by membership
UnitedHealthcare is the largest insurer in the U.S., according to a July 2023 report from Value Penguin.
Florida physician pleads guilty to antitrust conspiracy that limited cancer options
Oncologist William Harwin, MD, former president and managing partner of Fort Myers-based Florida Cancer Specialists & Research Institute, has pleaded guilty in a conspiracy to allocate oncology treatments for cancer patients.
Cigna Healthcare cuts 25% of prior authorization requirements
Cigna Healthcare is removing nearly 25 percent of medical services from prior authorization requirements, cutting more than 600 codes.
Insurer-health system breakups: 3 cases to know
Here are three health system and payers splits since May:
California legislature takes action to eliminate prior authorization
The California legislature is considering a bill that would prohibit prior authorizations for any healthcare service if the plan or insurer approved or would have approved not less than 90 percent of the prior authorization requests a provider submitte…
Physicians could be in financial danger with this Stark law change
Physician groups who provide certain medical equipment, devices and supplies to their Medicare patients could be in violation of Stark law following the end of the COVID-19 public health emergency, attorneys from law firm Epstein Becker & Green wro…
Commonwealth Health's physician group can't enforce noncompete law on former surgeon
A judge has ruled that Commonwealth Health’s physician group, Commonwealth Physician Network, cannot prevent its former surgeon from working locally for Geisinger, The Times-Tribune reported Aug 21.
UHC Texas adds 4 medications to Medicaid prior authorization list
Beginning Sept. 17, UnitedHealthcare Texas will begin requiring prior authorization for four medications based on new state guidelines for Texas’ Medicaid program.
US representative launches investigation into Medicaid prior authorization denials
Rep. Frank Pallone Jr., a Democrat from New Jersey, has announced an inquiry into the high rate of prior authorization denials by Medicaid managed care plans.
