ASC Coding, Billing & Collections

Two pharmacy owners and a physician have been convicted for their role in a healthcare fraud, money laundering and tax evasion scheme. 

Here are five numbers about certificate-of-need laws that ASC leaders should know:

U.S. Senators Bill Cassidy, MD, Catherine Cortez Mastro, Elizabeth Warren and Marsha Blackburn have introduced bipartisan legislation to improve the transparency of Medicare Advantage plans. 

The Federal Trade Commission proposed a rule in January that would keep employees free from noncompete agreements nationwide. 

Insurance giant UnitedHealth Group is facing a lawsuit alleging it used an artificial intelligence algorithm to wrongfully deny coverage to older patients for care under its Medicare Advantage health policies, Bloomberg Law reported Nov. 14.

A 2023 report from insurer Humana shows that Medicare Advantage patients receiving care through value-based arrangements spend more time with their physicians and have better care outcomes than their non-value-based counterparts. 

The Justice Department filed to dismiss the government's indictment against Deerfield, Ill.-based ASC chain SCA Health, formerly Surgical Care Affiliates, for allegedly agreeing with competitors to not poach senior-level employees. 

The CMS ASC payable list has seen sizable change in the last five years — through both additions and removals. 

HHS' Office of Inspector General has issued an advisory opinion on a new safe harbor to kickback laws that aims to increase quality while reducing costs, according to a Nov. 14 article in JDSupra from law firm WilmerHale. 

HHS' Office of Inspector General released its General Compliance Program Guidance on Nov. 6, providing an overview on Stark law and physician referrals.