• What a $345M Stark law ruling means for physician pay structure 

    Indianapolis-based Community Health Network recently agreed to pay $345 million to resolve claims it violated the False Claims Act and Stark law, indicating the importance for providers to pay close attention to physician compensation arrangements, law firm Baker Donelson wrote in a Jan. 22 article published by JDSupra. 
  • What every physician should know about Stark law

    Many physicians have experienced challenges stemming from Stark law, which bans them from making referrals for Medicare-payable health services if the physician or immediate family member has a financial relationship with the entity. 
  • Which states have banned noncompetes?

    Earlier this year, New York Gov. Kathy Hochul vetoed a bill that would've banned noncompetes and added the state to a short list of those prohibiting noncompetes. 
  • The payer trends defining ASCs

    Two ASC leaders joined Becker's to discuss the payer trends that are affecting ASCs in the most significant ways at the moment. 
  • What ASCs can expect from CMS' latest prior authorization ruling

    CMS has finalized prior authorization and electronic health information policy updates that are expected to create approximately $15 billion in savings over the next 10 years. 
  • nimble solutions appoints CEO

    St. Louis-based nimble solutions, an ASC revenue cycle management company, named Kelley Blair CEO.
  • Bill aims to push price transparency to ASCs

    A bill that would strengthen healthcare price transparency at ASCs has been introduced in the Senate, according to a news release from Indiana Sen. Mike Braun. 
  • ASC suit accusing Elevance of $5.4M+ in unpaid claims revived 

    A circuit court has reinstated a suit from the Costa Mesa, Calif-based South Coast Specialty Surgery Center accusing Blue Cross of California, which does business as Anthem Blue Cross, of racking up more than $5.4 million in unpaid claims. 
  • The payer behavior physicians want changed

    Five physician leaders joined Becker's to discuss the payer behavior they'd like to see changed in 2024. 
  • 3 payer rules that took effect Jan. 1

    This year is shaping up to be a big one for major U.S. payers, with several new rules going into effect. 
  • How ASC leaders, physicians are navigating payer relations in 2024

    The ever-changing payer landscape requires leaders to be nimble in order to navigate it successfully.  
  • FTC noncompete ban: Where the proposal stands 1 year later

    In January 2023, the Federal Trade Commission proposed a rule that would ban noncompete contracts for full-time employees and independent contractors. 
  • UnitedHealthcare vs. Cigna vs. Aetna: 15 updates for 2024

    UnitedHealthcare Group, Cigna and CVS Health-backed insurer Aetna, three of the largest U.S. insurers by membership, each had an eventful 2023. 
  • The Congress members fighting CMS' 2024 pay cuts

    Nearly 200 members of Congress have co-signed a bipartisan letter urging House and Senate leaders to pass legislation addressing 2024's Medicare physician pay cuts, according to a Jan. 4 report from the American Medical Association. 
  • Cigna in 'advanced talks' to sell Medicare Advantage business

    Cigna is reportedly in "advanced talks" to sell its Medicare Advantage business to Chicago-based health insurer Health Care Service Corp., according to a Jan. 3 report from The Wall Street Journal.
  • 5 numbers on HOPD vs. ASC costs

    The reimbursement disparity between hospital outpatient departments and ASCs is frustrating leaders as costs soar. 
  • 3 provider fraud schemes in 5 weeks

    Here are three providers who have been charged or sentenced for their alleged roles in fraud schemes that Becker's has reported on since Dec. 5:
  • Sarasota Memorial, UnitedHealthcare strike outpatient Medicare Advantage agreement

    Sarasota (Fla.) Memorial Health Care System has finalized a new agreement with UnitedHealthcare allowing its urgent care, outpatient facilities and First Physicians Group healthcare providers to remain in-network with UHC's Medicare Advantage plan, according to a Dec. 29 report from the Herald-Tribune. 
  • New York governor vetoes noncompete ban

    New York Gov. Kathy Hochul has vetoed a bill that would have banned all noncompetes, The Wall Street Journal reported Dec. 23.
  • A 2024 Stark law compensation update physicians need to know

    ASCs, physician groups and hospitals can provide non-monetary compensation to physicians up to an amount of $507 for the calendar year 2024, according to a Dec. 27 Lexology report. 

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