ASC Coding, Billing & Collections

A Yuma, Ariz., physician’s clinic has closed after Ifran Fazil, MD, was arrested and charged with four felonies, including defrauding Arizona’s Medicaid program, money laundering and possessing dangerous drugs, leaving patients scrambling for care and waiting months for medical records,…

Satellite Med, a primary care practice in the Cookeville, Tenn., area, permanently closed after 20 years of operation, with owner James Cates, MD, citing a decade of declining reimbursements and insurance company interference in clinical decision-making as the primary drivers.…

CMS released its proposed CY 2027 Medicare Physician Fee Schedule July 14, setting up another cycle of physician pay cuts at the same time the companion CY 2027 OPPS/ASC proposed rule moves facility payment rates in the opposite direction.  The…

Fort Myers, Fla.-based NeoGenomics Laboratories agreed to pay $9.8 million to resolve allegations that it violated the Anti-Kickback Statute and Stark law through two separate arrangements involving referring physicians and independent consultants, according to a settlement agreement signed July 20,…

There were several significant national-level healthcare policy updates announced, passed or developed in the last month with numerous implications for ASCs. Here are five policies ASC leaders should take note of in the last month:  1. The Senate Health, Education,…

Washington lawmakers advanced the most significant Medicare Advantage prior authorization reform in years this week. But as Congress moves to curb delays and denials for beneficiaries enrolled in private Medicare plans, CMS is simultaneously expanding prior authorization in traditional Medicare…

UnitedHealthcare’s frustration with the No Surprises Act’s arbitration system became explicit on the insurer’s second-quarter earnings call, but it is only the most recent escalation in a fight that has stalled in Congress, lost repeatedly in federal court and is…

Billing and payment are among the most complex aspects of day-to-day administrative work for ASC leaders — and it’s rarely due to the ASC itself. Ellen Rostron, business operations manager at Boston Out-Patient Surgical Suites, told Becker’s that a common…

A group of physician lawmakers has introduced the Patients First Act, which revamps the Medicare physician fee schedule, expands access to care and improves incentives for independent practices.  Here are eight notes on the new legislation, according to a July…

CMS’ proposed Medicare payment policy includes another 1.68% cut to reimbursements for surgeons.  The CMS calendar year 2027 Medicare Physician Fee Schedule’s proposed rule could have an even larger effect on spine and orthopedics. Specialty-level analysis estimates that orthopedic surgery…