A Louisiana man pleaded guilty to his role in a $3.8 million fraud scheme involving medically unnecessary medical equipment and physician kickbacks, the Justice Department said in a June 5 news release. What happened? What’s next?
ASC Coding, Billing & Collections
A Houston pain management physician agreed to pay $390,082 to settle allegations that he submitted false Medicare claims for surgical implantation of neurostimulator electrodes, the Justice Department said in a June 3 release. What happened?
A House GOP bill, cleared May 22 by a 215–214 vote, would eliminate the pass-through entity tax deduction, a move that many physician groups warn would raise taxes on private medical practices, more than 20 national medical organizations wrote in…
nimble solutions, the leader in surgical revenue cycle management, today announced its acquisition of Contego, a specialized firm focused on revenue optimization for out of-network surgeons, including their ASCs and office-based surgical practices. This partnership expands nimble’s capabilities in supporting…
A federal district court dismissed a lawsuit on May 23 filed by Neurological Surgery Practice of Long Island (N.Y.), ruling that HHS met its legal obligation under the No Surprises Act by creating a method for selecting independent dispute resolution…
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In 2025, CMS finalized a 2.9% pay increase for hospital outpatient and ASC services, based on a 3.4% market update, minus a 0.5% productivity adjustment. Several major insurance companies are following suit, also steering volume toward the outpatient setting, as…
A physician in Frisco Texas has agreed to pay $3.5 million to resolve claims he violated the knowingly submitting or causing the submission of false claims for evaluation and management services that were not performed, the Justice Department said in…
Elevance Health, parent company of Blue Cross Blue Shield of Georgia, has filed a lawsuit against billing company HaloMD and two physician groups accusing them of exploiting the federal arbitration system established under the No Surprises Act, according to court…
A Kansas City, Mo.-based man has pleaded guilty to a Medicare fraud scheme involving false claims for cancer genetic testing and cardiovascular genetic testing, the Justice Department said in a May 29 news release. What happened? What’s next?
The Trump administration recently issued a request for information seeking input on how to improve drug price transparency, alongside other initiatives aimed at increasing price transparency in healthcare. Here are five updates on price transparency: 1. HHS, the Labor Department…