The Justice Department’s new pilot program, which rewards whistleblowers who provide evidence of corporate misconduct, could lead to an uptick of whistleblower activity related to private payer fraud, The National Law Review reported Aug. 15
Category: ASC Coding, Billing and Collections
59% of physicians say productivity-based pay is 'unfair'
Most physicians expressed disapproval of relative value unit-based pay in Medscape’s 2024 “Physicians and RVUs Report.”
CMS inks final 2025 rules for hospitals: What ASCs need to know
On Aug. 1, CMS released the nearly 3,000-page final rules on reimbursement and other inpatient issues, according to an Aug. 7 blog post by Coronis Health.
Cardiology, gastroenterology & orthopedic procedures at ASCs: How the big 3 stack up
Differences in reimbursement between ASCs and HOPDs are an ongoing pain point for surgery centers. However, many opportunities to profit off of specialty procedures remain, regardless.
Physicians beware: The Stark law issues raising alarms
Physicians are eyeing Stark law as the Department of Justice doubles down on enforcement, with an uptick in complaints-in-intervention and Stark-related settlements.
HOPDs versus ASCs: 3 common procedures
More than 80% of surgeries are now performed in an outpatient setting, according to the Ambulatory Surgery Center Association. ASC procedures are almost always less expensive than in hospital outpatient departments.
Physician consolidation driving procedures to HOPDs, not ASCs: Study
The vertical integration of physician groups and health systems is resulting in a push to procedures to hospital outpatient departments over ASCs, driving Medicare and patient out-of-pocket costs up, according to a study published July 25 in Science Di…
The state on the brink of an ASC boom
ASCs are flourishing across the country, with payers, patients and health systems taking note of the cost-savings potentials.
The specialists billing more than $5M each year
The average general surgeon billed commercial payers more than $11.6 million each year, according to an Aug. 1 analysis published by healthcare staffing firm AMN Healthcare.
Stark law amendment clears House committee
A House committee in June unanimously advanced legislation that would make permanent an in-office ancillary services exception to Stark law for drugs provided under Medicare.
