• 10 things to know about rise of Stark law violations

    Physicians and other healthcare providers should keep a sharp eye on potential Stark law allegations amid increasing federal scrutiny, law firm Arnold & Porter wrote in an April blog post. 
  • More bad news for FTC's noncompete ban 

    The Federal Trade Commission's ban on noncompete clauses is facing a preliminary injunction from a federal judge, and that injunction could potentially only apply to the plaintiffs suing the FTC, National Law Review reported July 22.
  • 9/10 physicians say prior authorizations hurt patient outcomes

    As many as nine out of 10 physicians say that prior authorization has a negative effect on patient outcomes, according to AMA’s survey of about 1,000 physicians nationwide.
  • Feds crack down on Stark law violations: 5 cases to know

    The Department of Justice is doubling down on Stark law enforcement, with an uptick in complaints-in-intervention and Stark-related settlements, law firm Arnold & Porter wrote in an April blog post. 
  • Cancer testing company to pay $900K to settle Stark Law violation allegations

    Palo Alto, Calif.-based oncology company Guardant Health will pay $913,933 to settle allegations it violated Stark Law. 
  • FTC investigating DaVita, Fresenius Medical Care's noncompetes

    The Federal Trade Commission is investigating DaVita and Fresenius Medical Care, two of the country's largest dialysis providers, over allegations their noncompete clauses illegally stifle smaller competitors, Politico reported July 13. 
  • Medicare Advantage in the news: 6 updates

    Here are six updates on Medicare Advantage that have made headlines recently, as reported by Becker's since June 25:
  • ASC vs. HOPD reimbursement for 10 common ASC procedures

    Reimbursement differences between hospital outpatient departments and ASCs are a longstanding point of contention among ASC professionals, with Medicare ASC payments increasing only marginally while Medicare hospital pay has seen comparatively significant jumps.
  • Self-employed vs. employed physicians: Medicare, Medicaid patient count

    Medicaid patient counts for self-employed and employed physicians were substantially lower than Medicare, according to Medscape's 2024 "Doctors Evaluate Medicare and Medicaid Report 2024," published July 12. 
  • 77% of physicians impacted by latest Medicare reimbursement cuts

    Earlier this year, Congress reduced physician pay rates under Medicare Part B by 1.7%, following a 2% cut in physician reimbursements in 2023. 
  • How do physicians feel about accepting Medicare patients?

    Nearly half of physicians are in support of accepting more Medicare patients at their practice, according to Medscape's 2024 "Medscape Doctors Evaluate Medicare and Medicaid Report 2024," published July 12. 
  • 5 numbers on HOPD vs. ASC reimbursements

    As more procedures gain approval to be conducted on an outpatient basis, reimbursement differences between various care settings have gained significant attention in the healthcare industry — among patients, executives and clinicians alike. 
  • The 25 most common ASC procedures

    Cataract excision surgery with removal of lens, without endoscopic cyclophotocoagulation, was the most frequently conducted procedure at ASCs in 2023, according to an analysis by healthcare market intelligence company Definitive Healthcare.
  • The growing burden of prior authorization

    The burden of prior authorization is growing as "payers seek new strategies to reduce outlays," according to a June 24 blog post from Coronis Health. 
  • Federal government challenges part-time physician noncompetes : 5 things to know

    The federal government is targeting New York City-based Mount Sinai Health System's inclusion of noncompete clauses in contracts for part-time physicians in a June 18 complaint filed with the National Labor Relations Board. 
  • FTCs' noncompete ban stalled

    The Federal Trade Commission's ban on noncompete clauses is facing a preliminary injunction from a federal court in Texas. 
  • Medicare Advantage scrutinized in Congress amid 'strong desire' to attack the problem

    Medicare Advantage plans have garnered animosity from providers due to the restrictive approval processes for needed services.
  • 76 physicians charged in $2.7B fraud schemes

    The Justice Department charged 193 people, including 76 physicians, for their alleged roles in fraud schemes nationwide.
  • CMS updates ASC coverage qualifications

    CMS has updated its coverage requirements for ASCs, The Joint Commission said in a June 26 news release.
  • ASCs see post-procedure payer clawbacks intensify

    As scrutiny increases on payer prior authorizations, health plans are using a new tactic to disrupt provider cash flows: post-procedure clawbacks.

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