Though the popularity of value-based care is rising, fee-for service payment models remain the status quo in several areas of healthcare.

Adam Bruggeman, MD, of Texas Spine Care Center in San Antonio, shared insight about the government and private payer landscape related to physicians and ASCs at the 19th Annual Spine, Orthopedic & Pain Management-Driven ASC event.

Though the Anti-Kickback Statute is federal law, it plays out differently from state to state. 

The federal healthcare Anti-Kickback Statute targets bribery and corruption within healthcare, according to a June 13 post from JD Supra.

Here are five prior authorization updates Becker's has reported on since May 25:

More than 230 U.S. Representatives and 61 Senators have authored letters urging CMS and the Department of Health and Human Services to finalize a proposal that would require insurers to streamline the prior authorization process for federally sponsored health plans. 

Alta Vista Healthcare & Wellness Centre, a skilled nursing facility in Riverside, Calif., and its management company, Rockport Healthcare Services, agreed to pay the U.S. and California $3.825 million to resolve kickback allegations.

Eleven percent of physicians attribute financial losses to practice issues such as business problems, reimbursement changes and a change in practice setting, according to Medscape's "Physician Wealth & Debt Report 2023."

The Commonwealth Fund released the 2023 Scorecard State Health System Performance report, examining quality healthcare access and affordability by state.

Physicians have alleged that executives within Nashville, Tenn.-based HCA Healthcare pressure hospital staff to persuade patients' families to initiate end-of-life care to boost metrics, according to claims made in a June 21 NBC News report. 

The Consolidated Appropriations Act of 2023 updated exceptions to Stark Law and Anti-Kickback law that will allow hospitals and healthcare providers to improve mental health services for physicians, attorneys from law firm ArentFox Schiff wrote in an article published by JDSupra on June 13. 

OptumHealth's network of providers and surgery centers is seeing strong outpatient surgery volumes, especially for hips, knees and senior services.

Harry Severance, MD, an adjunct assistant professor at Durham, N.C.-based Duke University School of Medicine, joined Becker's to discuss how physicians can leverage their power. 

Physicians and ASCs continue to raise concerns about the adequacy of Medicare reimbursement as operating costs continue to soar. 

MedPAC advocated for site-neutral pay for 66 outpatient procedures in a June 15 report, lowering 57 procedures to the office-based care rate and nine procedures to ASC rates.

Here are five healthcare antikickback cases to know from the last month:

The Ohio Legislature has introduced a new bill designed to streamline the prior authorization process by giving a yearlong exemption to providers who have an average of 80 percent or more of their requests approved, according to a June 12 report from NBC affiliate WKYC.

Here are four stories Becker's has covered about CVS Health's insurance company, Aetna, since April 20: 

The American Medical Association is taking action to ban noncompete contracts for physicians employed by for-profit or nonprofit hospitals, hospital systems or staffing company employers, according to a June 13 blog post from the AMA. 

Two major national payers, UnitedHealthcare and Cigna, recently switched or delayed planned policies due to pushback from industry leaders, patients and physicians.