Here are 20 recent statistics and updates regarding physician compensation heading into 2026: 1. CMS released its final rule for 2026 Medicare payments under the physician fee schedule, including two separate conversion factors. One for qualified practitioners participating in advanced…
ASC Coding, Billing & Collections
A former Indiana physician has agreed to pay $1.7 million to settle allegations by the Department of Justice that he submitted fraudulent claims to the state Medicaid program, Fox 59 (WXIN-TV) reported Jan. 28. Don Wagoner, MD, allegedly filed over…
The paperwork burden of prior authorization keeps climbing, and for some ASCs, the only way through is to treat it like a daily fight. Elisa Auguste, administrator at East Setauket, N.Y.-based Precision Care Surgery Center and vice president of the…
Rheumatologist Steven Mendelsohn, MD, agreed to pay $549,554 to resolve allegations under the False Claims Act, according to a Jan. 28 news release from the U.S. Attorney’s Office. What happened?
Site-neutral payment reforms have been under close watch by ASC leaders over the last several years as the industry continues to advocate for financial parity with HOPDs. CMS’ 2026 Hospital Outpatient Prospective Payment System rule advances a major step toward…
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In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting unsupported diagnosis codes to Medicare Advantage. The government alleged the scheme…
Elisa Auguste, administrator at East Setauket, N.Y.-based Precision Care Surgery Center and vice president of the New York State Association of ASCs, joined Becker’s to discuss how deeper collaboration between payers, providers and ASCs could improve the prior authorization process…
The Department of Justice announced Jan. 12 that False Claims Act settlements in 2025 exceeded $6.8 billion—the highest annual total in the history of the statute. In a Jan. 26 report, JD Supra outlines four other key takeaways from the…
Medical malpractice verdicts topping $10 million — often dubbed “nuclear” awards — are becoming more common as juries hand down eye-popping damages for catastrophic injuries and wrongful deaths. Physician groups, including the American Medical Association, have warned that the post-COVID-19…
Brian August, MD, a physician in El Paso, Texas, has agreed to pay $200,000 to resolve allegations that he violated the Controlled Substances Act, the False Claims Act and the Texas Health Care Program Fraud Prevention Act. According to a…