Commercial insurers paid an average of $1,489 more for common procedures at hospital outpatient departments than at ASCs in 2024, a 78% mark-up, according to a study published in Health Affairs in October. Researchers analyzed negotiated rate data from UnitedHealthcare,…
ASC Coding, Billing & Collections
Here are six major updates from Cigna in the last 30 days: 1. Beginning in January 2026, The Cigna Group and CVS will offer discounted infertility medications through TrumpRx. Cigna’s Evernorth pharmacies — Freedom Fertility and VFP Pharmacy Group —…
The vast majority of U.S. clinicians and office administrators trust artificial intelligence to handle prior authorization, according to a survey conducted by Cohere Health, a healthcare technology company. Among 200 respondents, 99% of clinicians and 96% of administrators expressed confidence…
Massachusetts’ certificate-of-need law is allegedly forcing referrers to recommend patients cross state lines to access affordable radiology services, Radiology Business reported Oct. 13. Amy Boutwell, MD, a private practice internist in Lexington, Mass., told Valley News Oct. 11 that she…
The federal shutdown reached its third week as Democrats and Republicans continued a stalemate over how to fund the government. In an Oct. 10 podcast, Bill Prentice, CEO of the Ambulatory Surgery Center Association, unpacked the impasse and what it…
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Several recent updates to reimbursement policies by both CMS and commercial payers could have a significant impact on ASCs and their financial stability UnitedHealthcare cuts CRNA reimbursements On Oct. 1, a UHC policy update went into effect that cuts reimbursements…
Becker’s has recently reported on four physicians who have filed or won lawsuits against their former employers. 1. John Murphy, MD, an OB-GYN, filed a lawsuit against Bend, Ore.-based St. Charles Health system, alleging it forced him into closing his…
A number of federal policies proposed or enacted in the last year are expected to have a significant impact on ASCs. In July, CMS released its proposed rules for 2026, which included the addition of hundreds of procedures to the…
Here are five notable developments from Cigna over the last month: 1. The Cigna Group has named Eva Borden as chief product officer for its commercial insurance business. Ms. Borden, who joined Cigna in 1999, has held multiple leadership roles.…
An OB-GYN in Reno, Nev., has been arrested for allegedly defrauding healthcare programs by submitting false claims for unnecessary gynecologic tests and surgeries, some of which caused serious medical complications, the Justice Department said in a Sept. 25 news release.…