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…
ASC Coding, Billing & Collections
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…
The Federal Trade Commission is ramping up scrutiny of healthcare markets, and physicians are likely to feel the effects. Here are 10 things to know: 1. The FTC is forming a dedicated Healthcare Task Force. FTC Chair Andrew Ferguson directed…
There have been a flurry of CMS policy updates and controversies over the course of the last month that could reshape reimbursement, supply chain and clinical decision-making for ASC leaders and physicians. Here are four CMS updates that ASC leaders…
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A Maryland OB-GYN has agreed to pay $507,500 to resolve False Claims Act allegations related to a telemarketing scheme designed to defraud Medicare and TRICARE, the Justice Department said in a March 26 news release. Between November 2014 and January…
The Ambulatory Surgery Center Association expressed support for federal legislation introduced March 25 by Reps. Beth Van Duyne, a Republican from Texas, and John Larson, a Democrat from Connecticut, that would change Medicare’s ASC payment system, according to a March…
An Alabama physician has been sentenced to 16 months in prison for a $2.7 million telemedicine fraud scheme involving medically unnecessary durable medical equipment and genetic testing, the Justice Department said in a March 20 news release. Between December 2018…
A Florida physician has pleaded guilty to making false statements in connection with a multimillion-dollar healthcare fraud scheme involving medically unnecessary genetic testing and durable medical equipment, the Justice Department said in a March 23 news release. Simon Grinshteyn, MD,…
The Justice Department and the state of Ohio on Feb. 20 filed a civil antitrust lawsuit against Columbus-based OhioHealth alleging the nonprofit health system has for years wielded its market power to lock out competition and drive up healthcare costs…