MHH Healthcare, a San Juan, Puerto Rico-based MA insurer, holds the highest average star rating out of the 15 largest Medicare Advantage insurers by membership, according to an analysis from Chartis.
Category: ASC Coding, Billing and Collections
New CMS transparency rules: 3 things to know
CMS has been phasing in new hospital price transparency requirements throughout 2024, with more changes set to take effect Jan. 1, 2025.
ASCs' new CMS survey: 5 things to know
Beginning in January 2025, the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems will be mandatory for ASCs and HOPDs. The new survey from CMS will gauge patient satisfaction in Medicare-certified HOPDs and ASCs,…
How malpractice suits affect self-employed vs. employed physicians
In a new survey, Medscape laid out how much self-employed and employed physicians are paying for malpractice premiums annually and how they feel about it.
How Medicare Advantage weighs on ASCs, physicians and hospitals
ASCs, physicians and hospitals alike have struggled with declining reimbursements, patient care issues and administrative burdens associated with Medicare Advantage plans — pushing some to drop the program entirely.
The hidden fees holding physicians back
Physicians are facing increasing economic challenges that threaten their autonomy as healthcare consolidations.
40% of physicians feel no obligation to take Medicaid patients
About 40% of physicians believe practitioners have no obligation to take on Medicaid patients, according to the second part of Medscape’s “Hot Topics in the Medical Profession Report 2024,” published Oct. 9.
3 major false claims cases and what they mean for fraud crackdown
From Stark law violations to the overturning legal precedents, several significant legal developments occurred within healthcare fraud enforcement in the third quarter of 2024.
Court declares qui tam whistleblower provisions unconstitutional in Florida practice's fraud case
A federal judge in Florida has dismissed a whistleblower lawsuit accusing a medical practice of inflating Medicare reimbursements, citing constitutional concerns over the False Claims Act’s qui tam provisions, law.com reported Oct. 4.
The rising burden of claims denials
Denials of claims are increasing, along with the administrative burden of managing them, according to Experian Health’s “2024 State of Claims” survey.
