Melbourne, Fla.-based Surgery Center of Viera sued Aetna on Oct. 13, according to court documents. The lawsuit alleges that Aetna used an undisclosed "mystery repricing program" to reimburse Viera $33,380 for a July 2018 spinal procedure that the ASC says cost $223,988.

Gil Tepper, MD, founder and CEO of Prime Surgeons in Los Angeles, spoke with Becker's ASC Review on changes he feels CMS should implement to give hospital outpatient departments and ASCs equal footing. 

The Stark regulations governing group practice rules will change Jan. 1. Business law publication Lexology laid out the new clarifications to group practice profit allocation. 

While CMS has made some policies directing surgeries to ASCs, it has also developed regulations ASC leaders see as unnecessary obstacles to outpatient procedure migration. 

The Covid-19 pandemic has accelerated the adoption of healthcare technologies focused on improving the patient experience while delivering on the expectation of accessible healthcare.

The 2022 Medicare Physician Fee Schedule proposed rule includes a large pay cut for physicians to meet the budget neutrality requirements.

A New York ophthalmologist pleaded guilty to collecting millions of dollars related to upcoding and fraudulently obtaining two government-guaranteed loans meant for COVID-19 pandemic relief, the U.S. Justice Department said this week.

CMS will move forward with site-neutral pay initiatives for outpatient clinic visits for hospital services provided at off-campus facilities.

CMS plans to require ASCs, along with all other healthcare providers, to mandate COVID-19 vaccines for staff as a condition of participating in Medicare.

Shifting routine outpatient procedures to ASCs can save commercially insured patients $684 on average per procedure, according to a Sept. 8 report from UnitedHealth Group. 

Five companies, including three pain management clinics, with the same owner had a second default judgment issued against them for participating in a multimillion dollar billing fraud scheme, the U.S. Justice Department said Sept. 2.

Cigna expanded its Affordable Care Act market reach to three states. 

The U.S. Justice Department is suing UPMC, its chair of cardiothoracic surgery and University of Pittsburgh Physicians in a whistleblower suit brought by a former UPMC physician.

Tustin, Calif.-based Orange County Multispecialty Surgery Center is suing Blue Cross and Blue Shield of North Carolina for allegedly paying only a fraction of its patients' bills, the Triangle Business Journal reported Sept. 1. 

ASCs are known as the high quality, low cost setting for surgical care, and CMS has taken notice.

From COVID-19 setbacks to CMS' proposal to cut 258 procedures from the outpatient-approved list, ASC leaders are working through many challenges to secure reimbursements.  

The proposed 2022 Hospital Outpatient Prospective Payment System and ASC Payment System, released July 19, outlined nine procedures slated to temporarily remain on CMS' office-based payable list in 2022.

CMS' procedure price look-up tool allows users to compare average pay for procedures in ASCs and hospital outpatient departments.

Steve Eisentrager, president of Ohio Valley Surgical Hospital in Springfield, spoke with Becker's ASC Review on the payer policy trends to which he's paying attention.

Anthony Romeo, MD, executive vice president of the Musculoskeletal Institute of DuPage Medical Group in Downers Grove, Ill., was ready to perform orthopedic surgery on a sedated patient earlier this summer when his office received a surprising call.