Becker’s has reported on four physician fraud cases since July 21: 1. Harrisburg-based Eye Consultants of Pennsylvania has agreed to pay $790,000 to resolve allegations that it submitted false claims to Medicare. Between Sept. 1, 2018, and April 7, 2025,…
ASC Coding, Billing & Collections
CMS released the 2026 proposed payment rule for hospital outpatient departments and ASCs on July 15. The proposal included the addition of 276 procedures to the Covered Procedures List for ASCs. It also proposed phasing out the inpatient-only list, beginning…
Despite CMS’ most recently proposed boost to physician payments, years of reimbursement declines have pushed some physicians to stop accepting Medicare patients entirely. Health policy research group KFF recently released data showing the overall number and percentage of physicians who…
Harrisburg-based Eye Consultants of Pennsylvania has agreed to pay $790,000 to settle allegations of submitting false claims, the Justice Department announced July 22. What happened?
A physician in Kingsport, Tenn., has been accused of healthcare benefit fraud, making false statements and unlawfully distributing controlled substances, WJHL 11 reported July 21. What happened?
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Stark law due diligence in clinic acquisitions must include meticulous evaluation of physician ownership and compensation to prevent self-referrals, according to a blog post from attorney Aaron Hall. Here are 10 things to know about Stark law compliance and clinic…
CMS released the 2026 proposed payment rule for hospital outpatient departments and ASCs on July 15. The proposal included the addition of 276 procedures to the Covered Procedures List for ASCs. It also proposed phasing out the inpatient only list,…
An internist in Fair Lawn, N.J., has been charged with unlawfully distributing opioids, soliciting sexual favors from patients and defrauding New Jersey Medicaid, the Justice Department said in a July 18 news release. What happened?
CMS has proposed a 3.6% increase to the 2026 Physician Fee Schedule conversion factor for non-APM participants, alongside a 3.83% boost for those in qualifying alternative payment models. For the first time, the agency would implement separate conversion factors based…
President Donald Trump has pursued increased healthcare price transparency measures so far in his term through an executive order signed in February. Now, in alignment with that policy, CMS released updated proposals for price transparency July 15. Here are five…