ASC Coding, Billing & Collections

As healthcare continues to move toward value-based care, payment based on the model remains a point of contention, according to the Medical Group Management Association's "Annual Regulatory Burden Report."

UnitedHealth Group is the largest payer by 2021 revenue, according to a Sept. 1 report from ValuePenguin. 

Willingboro, N.J.-based former physician assistant Aaron Jones, 28, was sentenced to two years in prison for a scheme that defrauded payers millions of dollars, Press of Atlantic City reported Oct. 5. 

Community Health has filed a suit to recover nearly $10 million from Fresno, Ariz.-based physician group Santé Health System, The Sun reported Oct. 5. 

A federal judge ruled an antitrust suit, filed by former employees of Deerfield, Ill.-based SCA Health, can move forward against Dallas-based Tenet Healthcare, DaVita and UnitedHealth Group affiliates, Bloomberg Law reported Sept. 27. 

UnitedHealth Group is the insurer with the largest market share, according to a September report from ValuePenguin. 

Pharmaceutical company Biogen has agreed to pay $900 million to resolve allegations it paid kickbacks to physicians to prescribe Biogen drugs, the U.S. Justice Department said Sept. 26. 

While many procedures are migrating to the ASC setting, "historically" slow payer policy changes could create delays, according to administrator Brenda Carter. 

CMS reduced outpatient overpayments given for patients receiving inpatient services in other facilities by updating their system, according to an audit from the HHS Office of Inspector General. 

High patient deductibles are shifting the way physicians deliver care, according to Eric Anderson, MD, a pain management physician in Lewisville, Texas.