Category: ASC Coding, Billing and Collections

Arizona health system files $10M breach of contract suit against physician group 

Community Health has filed a suit to recover nearly $10 million from Fresno, Ariz.-based physician group Santé Health System, The Sun reported Oct. 5. 

SCA Health, USPI antitrust suit moving forward, judge rules

A federal judge ruled an antitrust suit, filed by former employees of Deerfield, Ill.-based SCA Health, can move forward against Dallas-based Tenet Healthcare, DaVita and UnitedHealth Group affiliates, Bloomberg Law reported Sept. 27. 

Market share of the 10 largest payers

UnitedHealth Group is the insurer with the largest market share, according to a September report from ValuePenguin. 

Biogen pays $900M to settle physician kickback allegations

Pharmaceutical company Biogen has agreed to pay $900 million to resolve allegations it paid kickbacks to physicians to prescribe Biogen drugs, the U.S. Justice Department said Sept. 26. 

‘Historically’ slow payers hindering ASC procedure migration, admin says 

While many procedures are migrating to the ASC setting, “historically” slow payer policy changes could create delays, according to administrator Brenda Carter. 

CMS changes reduced outpatient overpayments: OIG 

CMS reduced outpatient overpayments given for patients receiving inpatient services in other facilities by updating their system, according to an audit from the HHS Office of Inspector General. 

High patient deductibles are disrupting the ASC industry, physician says 

High patient deductibles are shifting the way physicians deliver care, according to Eric Anderson, MD, a pain management physician in Lewisville, Texas.

Stark Law changes: Physician compensation arrangements to keep an eye on

Hospitals and health systems need to update their physician compensation plans after CMS’ recent changes to the Stark Law, according to an article in JDSupra from the law firm Foley and Lardner. 

The 47 procedures ASCA wants CMS to add to the approved procedure list 

The Ambulatory Surgery Center Association submitted comments to CMS on the Medicare 2023 proposed payment rule Sept. 13, asking the organization to make updates that would benefit ASCs as “high-quality, lower-cost facilities for outpatient surgical car…

What procedures are migrating to ASCs?

From high-acuity spine to cardiac procedures, five ASC leaders joined Becker’s to share what procedures they see moving to the ASC setting.