Category: ASC Coding, Billing & Collections

CMS is adding prior authorization requirements for certain fee-for-service procedures under traditional Medicare as part of its new Wasteful and Inappropriate Service Reduction model. A total of 17 procedures, identified by CMS as especially vulnerable to fraud, waste or overuse, will be subject to this change. Among the affected services are epidural steroid injections for […]

The post CMS adds prior authorization for spine, pain management Medicare services: What ASCs need to know  appeared first on Becker’s ASC.

Healthcare consulting group Sg2, a Vizient company, released its “2025 Impact of Change Forecast” on June 23, laying out several growth trends that will impact ASCs over the next 10 years.  Here are 10 takeaways from the report: 1. The report projects total adult ASC volume to grow 21% over the next decade.  2. Gastroenterology, […]

The post ASCs’ projected patient surge: 10 new trends appeared first on Becker’s ASC.

Physician pay jumped 4.9% in the last year, according to AMGA’s 2025 Medical Group Compensation and Productivity Survey. The organization gathered data from more than 184,000 providers in 500 medical groups. Here are five notes to know: 1. Medical specialists experienced a 4% increase in average compensation year over year, closely followed by surgical specialists […]

The post Physicians see pay jump: 5 survey notes appeared first on Becker’s ASC.

In what the federal government called the “largest Justice Department healthcare fraud takedown in history,” 324 individuals — including 96 medical providers — have been arrested in connection with schemes that amount to $14.6 billion in fraud, according to a June 30 news release from the department. The investigations span billing fraud, kickbacks, opioid diversion, […]

The post Physicians among 96 medical providers charged in $14B fraud crackdown appeared first on Becker’s ASC.

Across the healthcare landscape, prior authorization is undergoing significant changes aimed at reducing administrative burden and expediting care delivery.  Here are three major updates to know: 1. Nearly 50 health insurers, representing commercial, Medicare Advantage and managed Medicaid plans covering 257 million Americans, have committed to simplifying and standardizing the process. Participating payers have pledged […]

The post What’s going on with prior authorization? appeared first on Becker’s ASC.

A Washington, D.C., physician has been sentenced to 18 years in prison for illegally prescribing narcotics in exchange for cash, the Justice Department said in a June 26 news release.  What happened? 

The post Washington D.C. physician sentenced to 18 years for ‘pill mill’  appeared first on Becker’s ASC.

A Bloomfield, Mich.-based physician was sentenced to four years in prison for a $6.3 million Medicare fraud scheme involving medically unnecessary orthotic braces, the Justice Department said in a June 26 news release.  What happened?

The post Michigan physician sentenced to 4 years for $6.3M fraud scheme  appeared first on Becker’s ASC.

Here are four physician fraud cases Becker’s has reported on since June 17: 1. Columbus, Ohio-based Robert Florea, MD, was sentenced to 24 months in prison for a $1.5 million Medicaid fraud scheme. Dr. Florea fraudulently billed the Ohio Department of Medicaid for over 5,100 pieces of medical equipment, primarily braces for joints and back […]

The post 4 physician fraud cases in 15 days appeared first on Becker’s ASC.

Columbus, Ohio-based physician was sentenced to 24 months in prison for a $1.5 million Medicaid fraud scheme, the Ohio Attorney General said in a June 25 news release.  What happened?

The post Former Ohio physician sentenced in $1.5M Medicaid scheme  appeared first on Becker’s ASC.

Treating personal injury patients can be a high-reward model—but for many providers, the administrative overhead makes it feel more like a liability than an opportunity. Delays in reimbursement, ever-changing documentation requirements, and a growing volume of legal requests have made PI care increasingly complex to manage. At the center of this problem is what experts […]

The post Reducing Administrative Burden in Personal Injury Care: Strategies for Providers appeared first on Becker’s ASC.