The federal physician self-referral law — better known as the Stark law — was enacted in 1989 and aims to curb physician self-referrals that could drive overutilization and higher costs. Decades later, it remains one of healthcare’s most complex compliance…
ASC Coding, Billing & Collections
As payers continue pushing care into lower-cost settings, ASCs are being held as a solution. But leaders at Deerfield, Ill.-based SCA Health say some reimbursement policies, particularly those around anesthesia, risk undermining the site-of-care strategy insurers are trying to advance.…
Federal policy is rapidly reshaping the ASC landscape in 2026. From CMS expanding the covered procedures list to new prior authorization models and mounting reimbursement challenges, ASCs are at once facing major growth opportunities and new operational constraints. As payers…
A former sales director for the Northeast region of a mobile medical diagnostics company that performed transcranial doppler scans was sentenced for conspiring to offer and pay kickbacks to physicians in exchange for ordering medically unnecessary brain scans, according to…
Physicians told Becker’s that the next major shift in medicine won’t be a new device or breakthrough drug, but the accelerating shift from fee-for-service to value-based purchasing. Cost pressures, patient frustration and employer fatigue are converging in ways that may…
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Bethany Cataldi, DO, Chesterton, Ind., was sentenced to 97 months imprisonment after pleading guilty to a $50 million healthcare fraud scheme, according to a Feb. 19 news release from the U.S. Attorney’s Office for the Northern District of Indiana. What…
ASC leaders say the pressure facing independent centers isn’t limited to reimbursement cuts, and that payer tactics that restrict network access and redirect referrals are gradually shrinking surgical volume. Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker’s that…
CMS isn’t just tweaking ASC policies in 2026; it’s remolding the financial and regulatory foundation of outpatient surgery. From a major expansion of procedures allowed in the setting to the phaseout of the Medicare inpatient-only list and rollout of AI-supported…
Here are six payer updates since the start of 2026 that ASC should know: 1. CMS finalized a 2.6% payment increase for ASCs in its November rule, continuing its use of the hospital market basket update, but SCA Health executives…
Timothy Doyle, of Selden, N.Y., was sentenced to 14 months in prison for conspiring to offer and pay kickbacks to physicians in exchange for ordering medically unnecessary brain scans, according to a Feb. 13 news release from the U.S. Attorney’s…