ASC Coding, Billing & Collections

Oscar Lightner, MD, a physician at a Houston pain management clinic, was sentenced to seven years in prison for operating a clinic that sold illegal prescriptions. 

Tulsa, Okla.-based Ascension St. John has joined Blue Cross Blue Shield of Oklahoma's Medicare Advantage network, according to a Nov. 30 report from the Owasso Reporter.

A Georgia Senate committee has recommended the repeal of certificate-of-need laws in their entirety, according to a Nov. 29 report from the panel. 

Tumwater, Wash,-based sleep disorder practice Innovative Sleep Centers will pay $644,562 to resolve allegations it improperly billed Medicare and Medicaid. 

Blue Cross Blue Shield of Texas is expanding its Medicare Advantage coverage for 2024, entering 80 additional counties in the state. 

A proposed bill in the Florida House would eliminate noncompete agreements for physicians, NBC affiliate WCTV reported Nov. 29.

Here are five recent CMS moves that are shaping the ASC industry:

Certificate-of-need laws, which require healthcare providers to receive government permission to build facilities, are an obstacle for ASC growth in many markets. 

Five ASC leaders recently joined Becker's to discuss how reimbursement issues remain one of the biggest challenges for surgery centers in many markets. 

A Kings Point, N.Y.-based physician has been found guilty in a kickback scheme that defrauded Medicaid and subjected patients to procedures they did not need.