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Justice Department sues to halt UnitedHealth Group deal and 3 more news items
Health insurers have made several moves to grow their networks, become more efficient and institute new policies over the last few weeks, and one major company was hit with a lawsuit by the Justice Department. -
UnitedHealth in the headlines: 6 updates from the last 30 days
UnitedHealth Group, parent company of ASC management company United Surgical Partners International, reported sizable year-over-year growth in 2021. -
Physician group to pay $100K to resolve kickback allegations: 5 details
Brockton Urology Clinic in Boston will pay thousands of dollars to settle allegations it accepted kickbacks from a hospital for services never provided, according to the Justice Department. -
National Medical Billing Services acquires 2nd company in 2022
National Medical Billing Services, a healthcare revenue cycle management company focused on ASCs, closed its second transaction of the year. -
GI surgeries more common on the coasts than any other region
Gastroenterology claims the highest case mix, on average, among the nation's 6,028 ASCs, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. -
Average ASC revenue per case for each specialty: 2022
Orthopedics tops the pack for ASC revenue per case, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. The specialty was only the fourth most-represented among ASC cases, however. -
How CMS is affecting the future of healthcare
From the dismissal of the inpatient-only list to the removal of procedures from the ASC-payable list, CMS plays a massive role in the success of an ASC. -
24% of physicians say prior authorization wait led to hospitalization of patient
Thirty-four percent of physicians reported that delays in processing a prior authorization led to a serious adverse event for a patient in their care, according to a recent survey from the American Medical Association. -
UnitedHealthcare adds prior authorization to physical, occupational therapy in 4 states
UnitedHealthcare now requires members to obtain prior authorization before undergoing physical and occupational therapy at multidisciplinary offices and outpatient hospitals in four states. -
UnitedHealthcare drops patient observation notice requirement
Chicago-based insurance provider UnitedHealthcare has ended its requirement in most plans for providers to submit an observation notification after a patient is discharged home, the company said Feb. 10. -
UnitedHealthcare vs. Cigna vs. Anthem: How the big 3 stack up
Payers UnitedHealthcare, Cigna and Anthem reported the largest year-end revenue in 2021. -
2 Texas physicians indicted in $300M kickback scheme
Two Laredo, Texas-based physicians were among 10 indicted in a $300 million healthcare fraud scheme Feb. 10, according to the Justice Department. -
6 CMS updates
The No Surprises Act, the federal law requiring ASCs and physician practices to provide cost estimates to self-pay patients, went into effect Jan. 1. -
ASCs must give cost estimates to patients: 7 details
ASCs and physician practices are required to provide cost estimates for expected charges to self-pay patients when scheduling procedures or services as part of the No Surprises Act, which went into effect Jan. 1. -
Aetna in the headlines: 5 updates in the last 30 days
Here are five updates from Aetna, one of the country's biggest payers, in the last 30 days: -
Michigan surgeon pleads guilty to $19.5M billing fraud: 4 details
A Bay City, Mich.-based vascular surgeon pleaded guilty to a multimillion dollar fraud scheme Feb. 8, according to the Justice Department. -
ASCA asks members to urge Congress to support ASC reimbursement legislation
The Ambulatory Surgery Center Association is asking members to write to Congress and ask them to support the Outpatient Surgery Quality and Access Act of 2021. -
Commercial payers driving cases to ASCs; orthopedics most primed for growth
A growing number of commercial insurers are revamping policies to push providers and patients out of the hospital and into ASCs, where procedures can be performed at a lower cost. -
Woman pleads guilty in $44M scheme to fraudulently bill cosmetic surgeries
A 69-year-old woman pleaded guilty to federal fraud charges after billing cosmetic surgeries at a California surgery center as medically necessary, the Justice Department said Feb. 4. -
Ask payers how you can share in the savings, says Surgery Partners exec
Shannon Yarrow, senior vice president of managed care at Brentwood, Tenn.-based Surgery Partners, joined "Becker's ASC Review Podcast" to talk about reimbursement opportunities for physicians doing outpatient procedures.