Physicians are eyeing Stark law as the Department of Justice doubles down on enforcement, with an uptick in complaints-in-intervention and Stark-related settlements.
ASC Coding, Billing & Collections
As of 2023, nearly half of U.S. hospital and health systems have at least one partnership, affiliation, or ownership interest in ASCs. Reports from industry publications indicate ASCs are becoming central to the overall financial strategy of extensive healthcare service…
More than 80% of surgeries are now performed in an outpatient setting, according to the Ambulatory Surgery Center Association. ASC procedures are almost always less expensive than in hospital outpatient departments.
The vertical integration of physician groups and health systems is resulting in a push to procedures to hospital outpatient departments over ASCs, driving Medicare and patient out-of-pocket costs up, according to a study published July 25 in Science Direct.
ASCs are flourishing across the country, with payers, patients and health systems taking note of the cost-savings potentials.
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The average general surgeon billed commercial payers more than $11.6 million each year, according to an Aug. 1 analysis published by healthcare staffing firm AMN Healthcare.
A House committee in June unanimously advanced legislation that would make permanent an in-office ancillary services exception to Stark law for drugs provided under Medicare.
ASCs in many markets are struggling to secure higher reimbursements and gain leverage in payer conversations.
Here are 10 multimillion-dollar Stark law settlements Becker's has reported on in two years:
Charleen Tacket, administrator of Vital Heart & Vein in Houston, joined Becker's to discuss how patient experience is often missed in conversations with insurance companies.