• Which states are targeting noncompetes?

    The Federal Trade Commission proposed a rule in January that would keep employees free from noncompete agreements nationwide. 
  • Lawsuit alleges UnitedHealth used AI to wrongfully deny claims

    Insurance giant UnitedHealth Group is facing a lawsuit alleging it used an artificial intelligence algorithm to wrongfully deny coverage to older patients for care under its Medicare Advantage health policies, Bloomberg Law reported Nov. 14.
  • Value-based care lowers costs, improves patient outcomes: Report

    A 2023 report from insurer Humana shows that Medicare Advantage patients receiving care through value-based arrangements spend more time with their physicians and have better care outcomes than their non-value-based counterparts. 
  • Justice Department files motion to dismiss SCA Health antitrust case 

    The Justice Department filed to dismiss the government's indictment against Deerfield, Ill.-based ASC chain SCA Health, formerly Surgical Care Affiliates, for allegedly agreeing with competitors to not poach senior-level employees. 
  • 59 procedures added to ASC payable list in last 5 years

    The CMS ASC payable list has seen sizable change in the last five years — through both additions and removals. 
  • HHS inspector general's latest anitkickback ruling: What ASCs need to know

    HHS' Office of Inspector General has issued an advisory opinion on a new safe harbor to kickback laws that aims to increase quality while reducing costs, according to a Nov. 14 article in JDSupra from law firm WilmerHale. 
  • What to know about Stark law & physician referrals

    HHS' Office of Inspector General released its General Compliance Program Guidance on Nov. 6, providing an overview on Stark law and physician referrals. 
  • The burden of prior authorizations: 5 key stats 

    Eighty-nine percent of providers said that prior authorizations were very or extremely burdensome, according to the Medical Group Management Association's 2023 "Regulatory Burden Report." 
  • Physicians and Stark law: 5 leaders' thoughts

    Stark law settled a record-breaking $9.2 million in voluntary self-referral disclosure settlements in 2022, and many physician leaders have experienced obstacles stemming from Stark law policy. 
  • Prior authorization delaying 97% of providers' necessary care 

    Ninety-seven percent of providers' patients have received delays or denials for necessary care due to prior authorization requirements, according to the Medical Group Management Association's 2023 "Regulatory Burden Report." 
  • Geisinger joins Capital Blue Cross Medicare Advantage network

    Danville, Pa.-based Geisinger has been added to Capital Blue Cross' Medicare Advantage network, beginning Jan. 1, according to a Nov. 9 report from The Valley Ledger.
  • Number of Medicare Advantage plan offerings remains stagnant as systems cut ties

    The average Medicare Advantage beneficiary can choose from a total of 43 plans for the 2024 enrollment period, the same number of plan options as 2023, according to data from KFF published Nov. 8. 
  • UnitedHealthcare providers by state

    California has the largest number of providers accepting UnitedHealthcare insurance plans statewide, in addition to having more ASCs than any other state, according to the most recent data from the payer's website. 
  • UnitedHealthcare in the headlines: 3 notes

    Here are three updates on UnitedHealthcare that Becker's has reported since Nov. 1:
  • 3 CMS rulings impacting ASCs

    Here are three recent rulings from CMS that affect ASCs: 
  • Indiana physician's lawsuit challenges state's noncompete law

    Pediatric intensivist David Lankford, MD, is suing his former employer, Fort Wayne, Ind.-based Lutheran Hospital, to get out of a noncompete clause in his contract, local PBS affiliate WFYI reported Nov. 2. 
  • Prisma Health plans to go out of network with UnitedHealthcare

    In August, Greenville, S.C.-based Prisma Health warned its patients that starting Jan. 1, the health system might be out of network with UnitedHealthcare. Now, as the negotiation deadline looms, it seems more and more likely, according to a Nov. 3 report from NBC affiliate WYFF. 
  • How much does it cost to employ a physician?

    The average cost of employing a provider full time in the third quarter of this year was $611,194, representing a rising cost of labor, according to data from Kaufman Hall.
  • How much do employed physicians earn through seeing patients?

    The average revenue earned by physicians and advanced practice providers via treating patients is on the rise, according to data from Kaufman Hall.
  • The 11 procedures added to the ASC-payable list

    CMS added 11 procedures to the ASC-covered list in the ASC Payment System Final Rule released Nov. 2 that were not included in the proposed rule. 

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