A bipartisan group of lawmakers has introduced the Provider Reimbursement Stability Act, legislation aimed at modernizing the Medicare Physician Fee Schedule to address decades of declining physician reimbursement, according to a March 31 news release. The bill was introduced by…
ASC Coding, Billing & Collections
A bill introduced in Congress on March 20 would tie ASC annual payment updates directly to the hospital outpatient department fee schedule increase factor. Currently, ASC payment updates and HOPD payment updates follow different formulas, a gap that historically has…
Two Sutter Health facilities, including an ASC, have agreed to pay $3.2 million to resolve allegations of failing to guard against the theft and diversion of controlled substances, the Justice Department said in a March 26 news release. Sutter Medical…
Despite policy efforts to increase reimbursement, spending per Medicare beneficiary on primary care physicians fell from $438 in 2017 to $420 in 2023, according to a March report published in Health Affairs. Here are 10 things to know: 1. Primary…
In December 2025, HHS, alongside the Labor and Treasury departments, proposed significant updates to healthcare price transparency rules. Comments for the proposed updates were due by March 2, 2026, and the proposals will take effect 12 months after the rules…
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As outpatient surgery continues its rapid migration from hospitals, a tension is emerging: the same payers pushing care into lower-cost settings are also making it harder to deliver it. From prior authorization delays and denials to shifting federal policy and…
Practice owners receive only 35% of income from salary compared to 69.5% for employees, with 40.8% from productivity and 18.2% from practice financial performance, according to the American Medical Association’s policy research perspective published March 2029. The report analyzed physician…
The Justice Department has accused NewYork-Presbyterian, a New York City health system, of stifling competition through restrictive payer contracts that steered patients away from lower-cost care settings, including ASCs. According to court documents, NewYork-Presbyterian leverages its market dominance to negotiate…
A Washington physician has been sentenced to one year and a day in federal prison for purchasing recalled CPAP and BiPAP devices, attempting to remove defective foam components and billing Medicaid for the adulterated equipment as if it were new,…
Amherst, N.Y.-based Excelsior Orthopaedics and Buffalo (N.Y.) Surgery Center have agreed to pay $2.4 million to settle a class-action lawsuit stemming from a 2024 data breach, according to a March 23 report from Claim Depot. The practice detected unusual activity…