ASC Coding, Billing & Collections

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. 

Eighty-nine percent of providers said that prior authorizations were very or extremely burdensome, according to the Medical Group Management Association's 2023 "Regulatory Burden Report." 

Stark law settled a record-breaking $9.2 million in voluntary self-referral disclosure settlements in 2022, and many physician leaders have experienced obstacles stemming from Stark law policy. 

Ninety-seven percent of providers' patients have received delays or denials for necessary care due to prior authorization requirements, according to the Medical Group Management Association's 2023 "Regulatory Burden Report." 

Danville, Pa.-based Geisinger has been added to Capital Blue Cross' Medicare Advantage network, beginning Jan. 1, according to a Nov. 9 report from The Valley Ledger.

The average Medicare Advantage beneficiary can choose from a total of 43 plans for the 2024 enrollment period, the same number of plan options as 2023, according to data from KFF published Nov. 8. 

California has the largest number of providers accepting UnitedHealthcare insurance plans statewide, in addition to having more ASCs than any other state, according to the most recent data from the payer's website. 

Here are three updates on UnitedHealthcare that Becker's has reported since Nov. 1: