ASC Coding, Billing & Collections

As many as nine out of 10 physicians say that prior authorization has a negative effect on patient outcomes, according to the American Medical Assocation's survey of about 1,000 physicians nationwide.

The Department of Justice is doubling down on Stark law enforcement, with an uptick in complaints-in-intervention and Stark-related settlements, law firm Arnold & Porter wrote in an April blog post. 

Palo Alto, Calif.-based oncology company Guardant Health will pay $913,933 to settle allegations it violated Stark Law. 

The Federal Trade Commission is investigating DaVita and Fresenius Medical Care, two of the country's largest dialysis providers, over allegations their noncompete clauses illegally stifle smaller competitors, Politico reported July 13. 

Here are six updates on Medicare Advantage that have made headlines recently, as reported by Becker's since June 25:

Reimbursement differences between hospital outpatient departments and ASCs are a longstanding point of contention among ASC professionals, with Medicare ASC payments increasing only marginally while Medicare hospital pay has seen comparatively significant jumps.

Medicaid patient counts for self-employed and employed physicians were substantially lower than Medicare, according to Medscape's 2024 "Doctors Evaluate Medicare and Medicaid Report 2024," published July 12. 

Earlier this year, Congress reduced physician pay rates under Medicare Part B by 1.7%, following a 2% cut in physician reimbursements in 2023. 

Nearly half of physicians are in support of accepting more Medicare patients at their practice, according to Medscape's 2024 "Medscape Doctors Evaluate Medicare and Medicaid Report 2024," published July 12. 

As more procedures gain approval to be conducted on an outpatient basis, reimbursement differences between various care settings have gained significant attention in the healthcare industry — among patients, executives and clinicians alike.