A Batesville, Miss., man has been hit with a civil judgment of more than $31 million for his role in an illegal kickback scheme targeting federal healthcare programs, the Justice Department said in a March 19 news release. Robert Crites,…
ASC Coding, Billing & Collections
An Anchorage physician was sentenced to six and a half years in prison for a $12.5 million healthcare fraud scheme and evading more than $4 million in taxes, the Justice Department said in a March 17 news release. Claribel Tan,…
Site-neutral payment reform is poised to reshape outpatient care economics, and industry leaders told Becker’s the policy could accelerate the migration of procedures away from hospital outpatient departments, while introducing new financial and access risks. Many view the shift as…
As orthopedic ASCs expand to keep apace with the outpatient shift, the economics behind that growth also become more complex. While ASCs are often positioned as a lower-cost alternative to hospitals, industry leaders say a growing delta between reimbursement and…
A California medical center has been shuttered and its owner charged with an $11 million fraud scheme, the San Diego County District Attorney’s Office said in a March 17 news release. Kim Huynh, 51, owner and operator of San Diego-based…
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A Wheeling, W.Va., physician was sentenced to 41 months in prison for tax fraud totaling nearly $2.5 million and attempting to obstruct a federal investigation, the Justice Department said in a March 17 news release. Nitesh Ratnakar, MD, who owned…
ASC leaders far and wide agree payers have the upper hand in reimbursement negotiations, but each has their own take on which particular set of tactics is doing the worst damage to the economics of outpatient surgery. From rates that…
Stark law, originally enacted in 1989 to curb physician self-referrals, but decades later, many physicians argue the law has calcified into a rigid framework outdated to the way modern healthcare actually works. Designed to protect patients from conflicts of interest,…
Two Missouri physicians are facing a False Claims Act complaint regarding alleged improper billing using the RST-Sanexas neoGEN-series electric stimulation device, the Justice Department said in a March 12 news release. The complaint targets St. Louis, Mo.-based chiropractor Michael Glickert,…
Facility fees have become a controversial component of the reimbursement structure for ASCs as some advocates say they disincentivize patients from utilizing lower cost settings for surgical procedures. “I call it a double whammy,” Kara Newbury, chief advocacy officer for…