All of healthcare has struggled with declining reimbursements, patient care issues and administrative burdens associated with Medicare Advantage plans.
Category: ASC Coding, Billing and Collections
AMA targets post-procedure clawbacks
Physician frustration is growing as prior authorization and other payer obstacles lead to increased retrospective payment denial.
The new era of Stark law, antikickback enforcement
Anti-Kickback Statute and the False Claims Act enforcement is entering a new era — turning away from enforcement of COVID-10 pandemic-era fraud, Law.com reported Nov. 7.
West Virginia hospital's Stark law case dismissed
A West Virginia federal district court has dismissed a false claims lawsuit filed against Thomas Health System, citing insufficient detail in the plaintiff’s allegations, according to court documents filed by Becker’s.
What a Trump win means for Medicare Advantage
During President-elect Donald Trump’s term, he decreased the average monthly plan premium for Medicare Advantage beneficiaries to the lowest rates MA plans had seen since 2007.
As hospitals slam site-neutral payments, ASCs find powerful allies
As many ASCs voice support for site-neutral payments, hospitals push back on legislator action advocating for such policies.
ASCs 'treading the water' amid new payer challenges
ASCs’ payer issues aren’t new, but many are now increasingly challenged by complex and restrictive payment policies set by insurers.
How physicians want to reform 1 of their 'biggest challenges'
Physicians are spending more time than ever on prior authorizations for treatments and procedures, which many say has a negative impact on patient care.
CMS' new hospital capacity ruling: 5 things ASCs need to know
CMS began requiring hospitals to report specific admission information on Nov. 1.
CMS updates ASC reporting requirements: 5 things to know
On Nov. 1, CMS finalized the 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule, confirming a 2.83% physician pay cut.
