Category: ASC Coding, Billing and Collections

UnitedHealthcare, CVS Health and Cigna were the three largest health insurance companies by 2022 revenue. 

Of the $2.2 billion in false claims settlements the Justice Department reported in the fiscal year ending Sept. 30, $1.7 billion involved healthcare organizations, the department said Feb. 7. 

Orlando-based physician group Florida Cardiology and 10 physicians will pay $2 million to resolve allegations that they submitted inflated claims to Medicare and Medicaid, the Justice Department said Feb. 13. 

Four lawmakers have reintroduced legislation to increase Medicare beneficiaries’ access to affordable outpatient surgical care.

Rising operating costs amid record-breaking inflation is making it difficult for ASCs to meet margins.

A bill introduced in the 2024 New York State Executive Budget would require regulatory review for certain physician practice and management service organization transactions. 

Most hospitals aren’t complying with federal price transparency rules that went into effect January 2021, with few consequences, according to the Fourth Semi-Annual Hospital Price Transparency Report from the PatientRightsAdvocate.org.

 Hudson, Ohio-based physician Deepak Raheja, MD, was sentenced to prison and must pay $2.2 million after pleading guilty to his role in a pharmaceutical kickback scheme, the U.S. Justice Department said Feb. 3.  

UnitedHealthcare made changes to its outpatient procedure group mapping that went into effect Jan. 1.

CMS updated ASC payment rates to 3.8 percent, the most critical reimbursement shift in 2022, according to VMG Health’s “ASCs in 2022: A Year in Review” report released Jan. 26.