CMS on July 15 issued a new proposal for the 2026 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System rule, as well as other reforms aimed at modernizing payments and expanding healthcare access. The proposed rule would affect…
ASC Coding, Billing & Collections
The transition to value-based care may seem daunting for many healthcare leaders, especially those who operate independently and have less margin for error when it comes to implementing new systems and initiatives. Flagler Health is a technology company offering AI…
Nearly 50 health insurers, representing commercial, Medicare Advantage and managed Medicaid plans covering 257 million Americans, recently committed to simplifying and standardizing the prior authorization process, and ASC administrators are approaching the announcement with cautious optimism. These participating payers have…
Mohammed Ahmad, MD, a physician based in Avon, Ohio, pleaded guilty to submitting fraudulent orders for durable medical equipment as part of a telemedicine scheme that defrauded Medicare, the Justice Department said in a June 10 news release. What happened?
As ASCs continue to battle declining reimbursement rates and high operational costs, many ASC leaders are looking to increase patient volumes and add ancillary services to relieve their bottom lines. During the session “Big Ideas to Grow Patient Volume Without…
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In the last year, there have been numerous policy shifts at both the federal and state levels affecting the daily operations and future growth of ASCs. Rachel Rose, a healthcare attorney in Houston, recently joined Becker’s to discuss the most…
As healthcare continues its shift toward outpatient care and value-based models, orthopedic surgeons are finding themselves at the intersection of payer dynamics and clinical innovation. Brett Shore, MD, president and CEO of Shore Orthopedics and an orthopedic surgeon with DISC…
Site neutral payments for hospitals and surgery centers are on the horizon, but they may not have the positive impact ASC owners hoped for. Hospital outpatient departments are paid significantly more than surgery centers for the same services, and lawmakers…
CMS is adding prior authorization requirements for certain fee-for-service procedures under traditional Medicare as part of its new Wasteful and Inappropriate Service Reduction model. A total of 17 procedures, identified by CMS as especially vulnerable to fraud, waste or overuse,…
Healthcare consulting group Sg2, a Vizient company, released its “2025 Impact of Change Forecast” on June 23, laying out several growth trends that will impact ASCs over the next 10 years. Here are 10 takeaways from the report: 1. The…