ASC Coding, Billing & Collections

A partially physician-owned hospital in Flower Mound, Texas, will pay millions to resolve allegations that it violated Stark Law, and the physician partner who blew the whistle will receive $3 million, according to a Dec. 2 Justice Department news release.

The American Society of Anesthesiologists condemned BlueCross BlueShield of North Carolina's alleged abuse of the No Surprises Act to coerce clinicians and practices into network agreements in a Nov. 22 statement shared with Becker's. 

Quincy (Ill.) Medical Group will pay $500,000 to settle allegations that it violated the False Claims Act, according to a Nov. 29 report by CBS and ABC affiliate KHQA.

The owner of pain management clinics, laboratories and a pharmacy in three states admitted to billing for unnecessary medical services and paying illegal kickbacks.

CMS is providing increased payments for several new products and procedures, including these four that are intended for spine surgery, cardiology, gynecology and sleep apnea.

Emad Bishai, MD, a pain management physician in The Woodlands, Texas, agreed to pay half a million dollars to resolve allegations he made false statements in a Paycheck Protection Program loan application and submitted false claims, according to the Justice…

One week after CMS finalized the 2022 rules and reimbursement rates, the agency has released an update raising the rate for closed-loop hypoglossal nerve stimulation, a sleep apnea procedure, by more than $7,000, according to a Nov. 10 news release…

CMS has created a new CPT code to describe the procedure associated with the EnPlace system, a minimally invasive meshless approach for pelvic floor fixation.

Here's how the three largest health insurers by revenue fared in the third quarter: 

The 2022 Hospital Outpatient Prospective Payment System and ASC Payment System finalized Nov. 2 removes 255 procedures from the ASC payable list.