CMS has released its final rule for Medicare Advantage and Part D for 2026, introducing several regulatory changes aimed at improving care coordination and beneficiary protections. While the rule includes important updates, such as streamlining prior authorization processes and clarifying…
ASC Coding, Billing & Collections
Physician reimbursement is often at the heart of healthcare policy debates, yet key perspectives remain overlooked. Six physicians joined Becker’s to discuss what they believe is missing in conversations about physician reimbursements. Editor’s note: Responses have been lightly edited for…
Constitution Billing and Financial Services, a subsidiary of Constitution Surgery Alliance, and medical coding company Milagro have partnered to launch a new billing platform at all CSA ASCs. Milgaro’s coding platform will be in use across CSA’s network, according to…
After about six hours of voting, the Senate passed an amended fiscal year 2025 budget resolution in a 51-48 vote on April 5, advancing efforts to potentially initiate the reconciliation process — and keeping proposed Medicaid cuts in focus. The…
Beckley, W.V.-based Med-Surg Physician Group and its owner Oluyemisi Sangodeyi, MD, agreed to pay $152,382 to settle allegations they submitted false Medicare and Medicaid claims and falsely certified compliance with program requirements, according to an April 2 news release from…
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A national sales director from Port Jefferson, N.Y., has pleaded guilty to a scheme involving kickbacks to physicians in exchange for ordering unnecessary brain scans, resulting in $70.6 million in fraudulent Medicare claims, according to an April 2 news release…
Gastroenterology has the highest percentage of block time utilization at ASCs, according to ASC software company HST Pathways’ latest “State of the Industry Report.“ Here’s the percentage of block time used at ASCs, by specialty, in 2024, according to data…
Rep. Mark Green, MD, a Republican from Tennessee, reintroduced a bill to Congress that would reform prior authorization requirements, The Hill reported March 27. “As a survivor of both colon and thyroid cancer, I know how critical it is to…
Healthcare consultant Gregg Gordon, who launched Surgical Solutions IPA in 2024, recently joined Becker’s to discuss how payers have “historically undervalued the ASC model,” and what it will take to shift that dynamic. Mr. Gordon, who has worked on both…
On Feb. 25, President Donald Trump signed an executive order targeted at boosting healthcare price transparency. Here are five other notes on the conversation surrounding price transparency for ASC leaders and physicians under the second Trump administration: 1. The order…