ASC Coding, Billing & Collections

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. 

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."