Category: ASC Coding, Billing & Collections

Physician among those indicted in $8M fraud scheme 

A federal jury has convicted a Kentucky physician, among other parties, for his role in a scheme to defraud Medicare and Kentucky Medicaid via Kentucky Addiction Centers, according to a March 26 news release from the Justice Department.  What happened?  What’s next?

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ASC cancellation rates tick up

ASCs are seeing a slight increase in case cancellations, averaging a 21% cancellation rate in 2024 — up from 20% in 2023, according to HST Pathways’ latest “State of the Industry Report.” Here are four more insights: 1. Seventy-seven percent of healthcare services using text messaging saw improved outcomes. 2. ASCs collected 51% of expected […]

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The certificate-of-need anomaly 

A March 14 MedPAC report found that while certificate-of-need laws are a major factor in ASC development, other state-specific factors, such as healthcare payment models and demographics, can blunt their effects.  Here are five things to know certificate-of-need laws and ASCs, according to the report: 1. More states are moving to change their certificate-of-need laws. […]

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Alabama weighs new rules for in-office surgeries: 10 things to know

The Alabama Board of Medical Examiners has proposed significant changes to regulations surrounding office-based surgeries in Alabama, according to an article by law firm Burr & Forman published in JD Supra March 24.  Here are 10 things to know about the proposed changes: 1. If passed, the new rules would repeal and replace existing regulations […]

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ASCs brace for impact of Medicaid cuts 

Medicaid is under scrutiny as Republican lawmakers eye big healthcare budget cuts for this year. Five ASC leaders joined Becker’s to discuss how they’re preparing for these cuts.  Question: With potential Medicaid cuts on the horizon, how concerned are you about their impact on ASCs, and what steps are you taking to prepare? Shakeel Ahmed, […]

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ASCs’ 20 most common Medicare procedures 

Extracapsular cataract removal with intraocular lens implantation is the most commonly billed Medicare procedure at ASCs, according to the latest report from the Medicare Payment Advisory Commission. Here are the 20 most commonly billed ASC procedures and their percentage of total volume: Procedure  2023 percent of volume Extracapsular cataract removal with intraocular lens implant insert […]

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The ‘tug-of-war’ over patient billing in New York

A law passed in New York last year sought to prohibit medical practices from requiring patients to sign consent-to-pay forms before receiving treatments or discussing costs.  But state officials, patient advocates and health professionals remain embroiled in a “tug-of-war” over the policy, according to a March 20 report from KFF Health News.  Here are 10 […]

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Physician-owned group to pay $8.75M to settle 401(k) excessive fee suit 

Emeryville, Calif.-based, physician-owned Vituity has agreed to pay $8.75 million to settle a class action lawsuit alleging mismanagement of its 401(k) plan, including excessive fees and imprudent investments, according to court documents accessed by Becker’s. What happened? What’s next? 

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Medicare ASCs continue to boom

The number of ASCs treating Medicare beneficiaries continued to rise in 2023, with an increasing volume of procedures and spending, according to the latest report from the Medicare Payment Advisory Commission. Here are five key facts to know: 1. The total number of Medicare-certified ASCs increased by 2.5% in 2023, reaching 6,308 facilities. This growth […]

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A ‘move in the right direction’ for price transparency

On Feb. 25, President Donald Trump signed an executive order targeted at boosting healthcare price transparency.  The order directs HHS and the Labor and Treasury departments to “rapidly implement and enforce” healthcare price transparency enforcement regulations. The order refers to regulations that President Trump introduced during his first term, which he said the Biden administration […]

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