ASC Coding, Billing & Collections

Residents in California-based Napa and Sonoma counties with Medicare Advantage plans through Senior Care Action Network will no longer have coverage beginning on Dec. 31, according to an Oct. 27 report from the Press Democrat. 

Here are five key numbers relating to Stark law to know:

Cigna, the fourth-largest insurer in the U.S. by membership, has received accolades — and scrutiny — in the last two months. 

A former executive of Medicare Advantage organization HealthSun Health Plans has been charged for her alleged role in a $53 million fraud scheme.

Pediatric surgical physicians saw a 5.7% jump in total cash compensation over the last five years, according to SullivanCotter's 2023 "Physician Compensation and Productivity Survey."

Prior authorization is one of the biggest issues facing ASCs and physicians — delaying care and increasing administrative burdens. 

Health systems have been cutting ties with Medicare Advantage plans left and right, including Raleigh, N.C.-based WakeMed and Zanesville, Ohio-based Genesis HealthCare System.  

ASCs have long struggled to secure adequate reimbursements. 

Each year CMS publishes star ratings to measure the quality of health and drug services from Medicare Advantage and Medicare prescription drug plans, or Part D plans.

Health First Health Plans is expanding its coverage into five counties in Florida, including the Orlando area, according to an Oct. 24 report from Florida Today.