10 payer updates in February

Here are 10 updates on payer policies, executive moves and other news in February for ASC leaders to know: 

Advertisement

1. A New York congressman is requesting public comment regarding patients’ experiences with Optum-owned medical clinics in the Hudson Valley region following complaints over care quality and accessibility.

2. UnitedHealth Group subsidiary Change Healthcare continues to send out data breach notifications a year after a cyberattack that disrupted the industry. 

3. The Wall Street Journal reported the Justice Department is investigating Medicare Advantage billing practices at UnitedHealth Group, a development that the insurer disputes. UnitedHealth has denied that the Department of Justice has opened an investigation into its billing practices. Sen. Chuck Grassley launched an inquiry into the company’s MA billing practices following the report. 

4. A federal judge is allowing a lawsuit against UnitedHealth Group to partially move forward, which alleges the company used an artificial intelligence algorithm to wrongfully deny Medicare Advantage patients post-acute care

5. Becker’s recently reported on 10 health systems choosing to scale back their insurance operations or get out of the business entirely. 

6. Multiple bills seeking to reform prior authorization are in the works in Montana. 

7. Aetna is walking back a proposed policy change involving reimbursement rates for services provided by nurse practitioners and nurse midwives. 

8. Lawmakers in Massachusetts have reintroduced a bill to establish a single-payer healthcare system in the state. 

9. Colorado lawmakers have also advanced a bill that would analyze the feasibility of instituting a statewide universal healthcare payment system for the third year in a row. 

10. The Cigna Group will tie executive pay to customer satisfaction as part of an initiative to improve members’ experiences.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.