Boston-based Ophthalmic Consultants of Boston has agreed to pay nearly $3.9 million to resolve False Claims Act allegations of improperly billing Medicare and MassHealth for office visits in addition to intravitreal injection procedures, the Justice Department said in a July…
ASC Coding, Billing & Collections
Two New York ophthalmology practices have agreed to pay a combined $2.3 million to resolve False Claims Act allegations of billing Medicare and Medicaid for medically unnecessary transcranial doppler ultrasounds through a kickback arrangement with a third-party testing company, the…
Physicians on RVU-based compensation plans often have no way of knowing whether the rate they are being paid is fair, and according to one gastroenterologist, that is often by design. The structural disconnect of wRVUs is well documented. Provider productivity,…
Payers are escalating public criticism of the No Surprises Act’s arbitration process, arguing the system is being exploited by a small number of providers as disputes and payouts climb to record levels. Health insurance CEOs, an industry coalition and at…
A Houston-based laboratory, its former CEO and a Florida businessman have agreed to pay a combined $36.4 million to resolve False Claims Act allegations of paying kickbacks and billing Medicare and Medicaid for medically unnecessary genetic testing, the Justice Department…
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Auto insurance provider Geico has accused two New York physician groups and the physician who owned them of billing the insurer more than $2 million for auto-accident treatments the company says were medically unnecessary or, in many instances, never performed…
Dallas-based Tenet Healthcare executives said they are still modeling how a proposed federal rule reshaping 340B drug reimbursement and hospital outpatient facility fees could affect the company’s ASCs, according to comments on the company’s July 24 second-quarter earnings call. What…
A Yuma, Ariz., physician’s clinic has closed after Dr. Ifran Fazil was arrested and charged with four felonies, including defrauding Arizona’s Medicaid program, money laundering and possessing dangerous drugs, leaving patients scrambling for care and waiting months for medical records,…
Satellite Med, a primary care practice in the Cookeville, Tenn., area, permanently closed Thursday after 20 years of operation, with owner James Cates, MD, citing a decade of declining reimbursements and insurance company interference in clinical decision-making as the primary…
CMS released its proposed CY 2027 Medicare Physician Fee Schedule July 14, setting up another cycle of physician pay cuts at the same time the companion CY 2027 OPPS/ASC proposed rule moves facility payment rates in the opposite direction. The…