A retired orthopedic surgeon in Fresno, Calif., was charged nearly $4,000 more for a cataract surgery at a hospital outpatient department than his wife who received the same procedure at an ASC, Kaiser Health News reported June 27. 

UnitedHealthcare is the largest insurer by revenue, according to a June 2022 Value Penguin report. 

Fifteen Texas physicians will pay a total of $2.83 million to resolve False Claim Act allegations involving kickbacks, the Justice Department said June 28.

ASCs have long faced challenges in securing reimbursements, but successful ASCs are focused on payer contracting strategy. 

ASCs in the Wichita, Kan., area are returning to pre-pandemic case numbers, Wichita Business Journal reported June 17.

Aetna, a CVS Health company, insurers about 39 million people. 

Anthem is one of the country's largest health insurers.

Arkansas physician Joe May, MD, was convicted on 22 counts over his involvement in a scheme to defraud Tricare of $12 million, the Justice Department said June 10.

Optum Ventures, CVS Ventures, Anthem and HLM Venture Partners announced they are investing in CareBridge, a value-based care company for patients receiving home and community-based services. 

A Muskegon, Mich., physician has pleaded guilty to billing Medicare, Medicaid and Blue Cross Blue Shield for services she didn't perform, the U.S. Justice Department said June 7. 

David Kowalski, MD, a physician with Springfield (Ill.) Clinic, a physician group with ASCs that dropped out of network with Blue Cross Blue Shield of Illinois last year after a pay dispute, shed light on the details of the dispute and what lies ahead during a presentation at the Effingham (Ill.) County Chamber of Commerce last week.

Many ASCs are facing increasing obstacles in the payer landscape, but ASC administrators and executives are developing strategies like direct-to-employer contracting and attracting patients to bypass them. 

After months of negotiations, Raleigh, N.C.-based WakeMed and UnitedHealthcare failed to reach an agreement on a new contract, The News and Observer reported June 1.

From a Maine physician group ending its contract with Anthem to Blue Cross Blue Shield updating its colonoscopy policy, here are six payer updates from the last 60 days:

As the healthcare industry continues to move away from fee for service and toward value-based care, alternative payment models are expected to become more popular among patients, insurers and providers.

With the trends in healthcare moving toward value-based care models, ASCs could be in the perfect position for growth. 

Three lawsuits have been filed against healthcare giant UnitedHealth Group and UnitedHealthcare in the last month — including two ASCs filing suits. 

Here are five updates from the last 60 day about one the country's largest insurers: 

Medicare per-procedure payments to hospital outpatient departments were 2.1 times larger than payments to ASCs, according to new research published by the Rand Corp. 

Oklahoma Heart Hospital South, a physician-owned hospital based in Oklahoma City, paid $1.2 million to settle billing fraud allegations May 16.