Here are three big payer moves disrupting the ASC industry:
1.On Sept. 1, UnitedHealthcare began its two-phased approach to eliminating prior authorization requirements. The goal of the new rule is to eliminate prior authorizations planwide by 20 percent. As of Sept. 1, codes were eliminated for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare individual exchange plans.
2. CMS pitched a 2.8 percent average rate increase for ASCs next year in the 2024 Hospital Outpatient Prospective Payment System, released July 13.
3. As of March 12, Cigna lowered reimbursements for non-medically directed procedures performed by certified registered nurse anesthetists by 15 percent.