CMS has released its final rule for Medicare Advantage and Part D for 2026, introducing several regulatory changes aimed at improving care coordination and beneficiary protections. While the rule includes important updates, such as streamlining prior authorization processes and clarifying the use of supplemental benefits, it stops short of addressing two of the most closely […]
The post CMS posts Medicare Advantage final rule: 5 things to know appeared first on Becker’s ASC.
Physician reimbursement is often at the heart of healthcare policy debates, yet key perspectives remain overlooked. Six physicians joined Becker’s to discuss what they believe is missing in conversations about physician reimbursements. Editor’s note: Responses have been lightly edited for clarity and length. Quentin Durward, MD. Neurosurgeon at the Center for Neurosciences, Orthopaedics, & Spine […]
The post What’s missing in conversations about physician reimbursements? appeared first on Becker’s ASC.
Constitution Billing and Financial Services, a subsidiary of Constitution Surgery Alliance, and medical coding company Milagro have partnered to launch a new billing platform at all CSA ASCs. Milgaro’s coding platform will be in use across CSA’s network, according to an April 4 news release. The platform will be used to improve AI-driven coding and […]
The post Constitution Surgery Alliance, Milagro strike ASC billing partnership appeared first on Becker’s ASC.
On April 3, the Senate passed an amended fiscal year 2025 budget resolution in a 52-48 vote, advancing efforts to potentially initiate the reconciliation process — and keeping proposed Medicaid cuts in focus. The resolution brings the Senate and House closer to a unified budget framework and retains a directive for the House Energy and […]
The post Senate passes budget resolution, Medicaid cuts remain a target appeared first on Becker’s ASC.
Beckley, W.V.-based Med-Surg Physician Group and its owner Oluyemisi Sangodeyi, MD, agreed to pay $152,382 to settle allegations they submitted false Medicare and Medicaid claims and falsely certified compliance with program requirements, according to an April 2 news release from the Justice Department. What happened?
The post Physician owner pays to resolve false claims allegations appeared first on Becker’s ASC.
A national sales director from Port Jefferson, N.Y., has pleaded guilty to a scheme involving kickbacks to physicians in exchange for ordering unnecessary brain scans, resulting in $70.6 million in fraudulent Medicare claims, according to an April 2 news release from the Justice Department. What happened?
The post Sales director pleads guilty to $70.6M physician kickback scheme appeared first on Becker’s ASC.
Gastroenterology has the highest percentage of block time utilization at ASCs, according to ASC software company HST Pathways’ latest “State of the Industry Report.“ Here’s the percentage of block time used at ASCs, by specialty, in 2024, according to data from 590 ASCs in 47 states:
The post ASC block utilization by specialty appeared first on Becker’s ASC.
Rep. Mark Green, MD, a Republican from Tennessee, reintroduced a bill to Congress that would reform prior authorization requirements, The Hill reported March 27. “As a survivor of both colon and thyroid cancer, I know how critical it is to start treatment as soon as possible,” Dr. Green told the news outlet. “Prior authorization can […]
The post Bipartisan bill would require physician involvement in prior authorization judgements appeared first on Becker’s ASC.
Healthcare consultant Gregg Gordon, who launched Surgical Solutions IPA in 2024, recently joined Becker’s to discuss how payers have “historically undervalued the ASC model,” and what it will take to shift that dynamic. Mr. Gordon, who has worked on both the provider and payer sides, said payers often focus narrowly on unit cost and reimbursement […]
The post Why payers still ‘undervalue’ ASCs appeared first on Becker’s ASC.
On Feb. 25, President Donald Trump signed an executive order targeted at boosting healthcare price transparency. Here are five other notes on the conversation surrounding price transparency for ASC leaders and physicians under the second Trump administration: 1. The order directs HHS and the Labor and Treasury departments to “rapidly implement and enforce” healthcare price […]
The post Trump administration & price transparency: 5 things to know appeared first on Becker’s ASC.
