A physician in Mission, Texas, was sentenced to 10 years in prison followed by three years of supervised release for carrying out a healthcare fraud scheme involving more than $118 million in false claims. Jorge Zamora-Quezada, MD, falsely diagnosed his…
ASC Coding, Billing & Collections
As cost pressures intensify, ASCs are increasingly positioning themselves as cost-effective alternatives to hospital settings — especially for high-cost procedures like joint replacements and spine surgery. For Benjamin Stein, MD, an independent orthopedic surgeon and co-founder of Germantown, Md.-based Capital…
Gillette, Wyo.-based Powder River Surgery Center and Blue Cross Blue Shield of Wyoming have partnered to launch a bundled payment program for total knee replacements, the organizations announced in a May 20 news release shared with Becker’s. The program, which…
While many ASCs rely on analytics platforms embedded in their EMRs or materials management systems, Germantown, Md.-based Capital Surgical Solutions decided to take a different route: building a custom analytics tool from scratch. Benjamin Stein, MD, an independent orthopedic surgeon…
A wave of medical malpractice reform is reshaping legislation across the country, with four states recently updating their laws, Best Lawyers reported May 19. According to the report, these reforms reflect a broader trend of tort reform focused on tightening…
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In the past year, ASCs across the country have seen a notable acceleration in payer changes — from tighter reimbursement models and rising costs to an industrywide push toward bundled payments and value-based care. The more than 28 leaders featured…
Becker’s has reported on two physicians groups who have faced allegations they have violated Stark law in the last week. Here’s what you need to know: Florida eye care group pays $615K for Stark law and kickback violations involving diagnostic…
Pinellas (Fla.) Eye Care, doing business as Gulfcoast Eye Care, agreed to pay $615,000 to resolve allegations it violated the False Claims Act and Stark law for its billing practices for transcranial doppler ultrasounds, the Justice Department said in a…
From sweeping drug price reforms to proposed staffing mandates and changes to Medicaid financing, here are five federal policy moves from the last week that ASCs need to know: CMS proposes updates for third round of Medicare drug price negotiations…
More than 60% of hospitals and health systems report that payers are pressuring them to ASC options for appropriate cases, according to Avanza’s Intelligence Hospital Leadership ASC Survey. Here are four key insights from the survey: