ASC leaders say payers too often treat outpatient surgery centers as “optional” sites of care, rather than essential providers that deliver hospital-level quality at a fraction of the cost. Two leaders joined Becker’s to discuss what insurers misunderstand about ASCs. …
ASC Coding, Billing & Collections
ASC leaders say prior authorization has become the most damaging pain point in payer relationships, delaying care even after clinical decisions are made and surgeries are scheduled. Four ASC leaders joined Becker’s to discuss the most frustrating parts of working…
A Maryland man was sentenced to 65 months in federal prison for leading a scheme that used stolen physician identities to submit thousands of fraudulent e-prescriptions for controlled substances, according to a Jan. 14 news release from the U.S. Attorney’s…
In November, CMS finalized its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2026, which included the addition of 573 codes to the ASC Covered Procedures List. This was a huge win for the Ambulatory…
A McAllen, Texas-based physician and a clinic employee have been sentenced for their roles in a kickback scheme that resulted in more than $3.1 million in Medicare losses, according to a Jan. 13 news release from the U.S. Attorney’s Office.…
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As surgical cases continue to shift out of the hospital and into outpatient facilities, physician offices have become increasingly common settings for less-invasive procedures. Here are three recent developments related to the rise in office-based procedures and the regulations surrounding…
In November, CMS finalized its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2026, which included the addition of 573 codes to the ASC Covered Procedures List. The update represented a significant advocacy win for…
Anderson, S.C.-based Clinical Laboratory, formerly known as Labtech Diagnostics, agreed to pay at least $6.8 million to resolve allegations it paid illegal kickbacks to physicians, according to a Jan. 8 news release from the Justice Department. What happened?
Memphis-based physician Sanjeev Kumar has been convicted for 40 criminal counts on healthcare fraud and improper reuse of medical devices, according to a Jan. 8 news release from the U.S. Attorney’s Office for the Western District of Tennessee. What happened?
From CMS updates to certificate-of-need laws, several policy changes in the last 18 months signal a major shift in how ASCs are taxed, licensed and regulated at both the state and federal levels. Below is a breakdown of the newest…