Ameet Vohra, MD, owner of Miramar, Fla.-based Vohra Wound Physicians Management, and his companies have agreed to pay $45 million to resolve allegations that they violated the False Claims Act by knowingly submitting claims for medically unnecessary surgical procedures to…
ASC Coding, Billing & Collections
CMS will make significant changes to ASC and outpatient surgery reimbursement next year. In the 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Final Rule, published Nov. 21, CMS outlined plans to increase ASC pay and allow for…
A physician in Cordele, Ga., has pleaded guilty to his role in a $24 million scheme to defraud Medicare. What happened? What comes next?
Here are three recent policy decisions by public and private insurers that are disrupting ASCs and physician practices: 1. Several physician associations are urging Elevance Health to abandon its new policy that penalizes hospitals and contracted facilities for using care…
Peter Bravos, MD, chief medical officer of Sacramento, Calif.-based Sutter Surgery Center Division, joined Becker’s to discuss how integrating ASCs with primary care, post-acute services and surgeon partners is key to success. Editor’s note: This interview was edited lightly for…
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In its finalized 2025 physician fee schedule, CMS included an “efficiency adjustment” of negative 2.5% work relative value units, sparking an outcry among physicians. Dozens of physician organizations condemned the rule and the reduction, with the American Medical Association arguing…
CMS is advancing a major step toward site-neutral payment reform in its proposed 2026 Hospital Outpatient Prospective Payment System rule, a move that could redefine how hospitals and ASCs collaborate. The proposal, which closed for public comment Sept. 15, aims…
As more procedures become approved for the outpatient setting and hospitals and health systems’ interest in the ASC space grows, leaders are narrowing their sights on certain specialties for strategic investment and expansion. Les Jebson, administrator of Prisma Health’s Orthopedics…
On Oct. 31, CMS issued its final policy changes for Medicare payments under the Physician Fee Schedule, alongside other shifts in Medicare policy. The update comes after suspicion from ASC leaders that the update may be delayed amid the ongoing…
Montana’s number of ASCs, home health agencies and inpatient addiction treatment centers have grown by 12.5% since its certificate-of-need law was repealed in 2021, according to an October report from the Frontier Institute. Here are four more things to know…