ASC Coding, Billing & Collections

Zanesville, Ohio-based Genesis HealthCare System will no longer accept Anthem or Humana Medicare Advantage plans beginning in 2024. 

Columbia, Tenn.-based payer Farm Bureau Health Plans has added Nashville, Tenn.-based Ascension Saint Thomas to its Medicare Advantage provider network. 

CMS settled a record-breaking $9.29 million in Stark law voluntary self-referral disclosure settlements in 2022, according to recent CMS data.

Morgantown-based West Virginia University Medicine has launched an in-house health insurance services company, Peak Health, which has been serving WVU Medicine employees. Now, the system is expanding its offerings to Medicare-eligible patients throughout the state, according to an Oct. 19…

HHS' Office of the Inspector General has confirmed broad protection of employee safe harbor under anti-kickback laws in a recent ruling involving physician ownership of an ASC, according to an Oct. 17 article in JDSupra written by law firm Sheppard…

CMS is floating the implementation of a separate add-on payment for healthcare common procedure coding system code G2211 in its 2023 Medicare Physician Fee Schedule, according to an Oct. 13 report in JDSupra written by law firm Reed Smith. 

From negotiating new contracts to expanding plans, here are five moves from these three major payers since Oct. 2: 

Health insurer Cigna has been ordered to pay over $172 million to settle claims that it submitted false diagnosis codes to Medicare Advantage, according to an Oct. 2 report from CBS News.

Cigna healthcare is expanding its Medicare Advantage plans to patients in Nevada for the first time, launching in two counties in the Las Vegas area. 

This year, the U.S. Office of the Inspector General conducted an audit of insurer Aetna's Medicare Advantage program to ensure that selected diagnosis codes Aetna submitted to CMS for use in CMS' risk adjustment program complied with federal requirements.