A Tennessee clinic owner and physician has been charged with prescribing more than 5.6 million pills and doses of controlled substances without a legitimate medical purpose over more than eight years, the Justice Department said in a June 23 news…
ASC Coding, Billing & Collections
The decision to leave hospital employment for independent practice is not just a financial calculation; for many physicians, it is a geographic one. Ahmed Hasan, MD, president of Lehigh (Pa.) Gastroenterology Associates, knows physicians who recently went independent and are…
The Justice Department has announced its 2026 National Health Care Fraud Takedown, charging 455 defendants, including 90 physicians and other licensed medical professionals, in schemes involving more than $6.5 billion in false claims, the department said in a June 23…
The headline number in most physician compensation reports is total cash compensation, which is base salary plus bonuses plus profit-sharing, but that figure doesn’t show how much depends on productivity metrics, patient satisfaction scores or quality measures outside their control. …
The federal agency that oversees Medicare is moving to place ASCs inside the same episode-based payment framework that has governed hospital joint replacement care since 2016, and ASC operators have roughly 18 months to figure out what that means for…
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Noncompete agreements, certificate-of-need laws and tax incentives are some of the most powerful policy levers shaping the way that independent physicians practice. Marcelo Hochman, MD, a Charleston-based independent physician and former president of the Independent Doctors of South Carolina, has…
CMS finalized a rule June 12 that significantly reshapes how accrediting organizations operate, and the new requirements signal more rigorous, standardized and independent surveys ahead. The rule, titled “Strengthening Oversight of Accrediting Organizations and Preventing AO Conflicts of Interest,” targets…
In 2024, seven major Stark law indictments contributed to a record-breaking 979 qui tam lawsuits, with False Claims Act settlements and judgments totaling $2.92 billion by the federal government’s fiscal year-end. The enforcement wave was built across five years of…
A Louisiana nurse practitioner who authored books on Medicare regulations has been sentenced to 87 months in prison for causing more than $12 million in fraudulent Medicare claims for medically unnecessary cancer genetic tests, the Justice Department said in a…
The Centers for Medicare and Medicaid Services added 573 procedures to the ASC covered procedures list for 2026 — 302 newly approved codes and 271 coming off the inpatient-only list. For the Ambulatory Surgery Center Association, which spent years in…