A Frederick, Md. oncology practice and its physician owner have agreed to pay $1.45 million to resolve False Claims Act allegations of billing Medicare, Medicaid and the VA for chemotherapy drugs that were never paid for or never administered to…
ASC Coding, Billing & Collections
CMS proposed a rule July 2 that would revise Medicare payment rates for HOPDs and ASCs starting in 2027. Here are five things ASC leaders need to know. 1. More surgeries will shift to ASCs. The rule proposes continuing to…
A jury has awarded urologist Deborah La Scola, MD, more than $6.8 million in a lawsuit against St. Louis-based SSM Health, finding the health system retaliated against her after she repeatedly complained about pay disparities between herself and her male…
Cardiology, gastroenterology and primary care are losing independent practices at a pace that separates them from the rest of the field, driven by a combination of Medicare payment erosion, private equity consolidation and hospital acquisition pressure. Between 2012 and 2024,…
The HHS Office of Inspector General has issued an unfavorable advisory opinion finding that a home health agency’s payment to a software vendor for referral management services would violate the Anti-Kickback Statute, according to a June 25 opinion. Under the…
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Some surgical assistants are using arbitration provisions in federal billing law to collect far more than the surgeons they assist, according to The New York Times. Surgical assistants are typically paid a standard fee equal to about 16% of a…
A Des Moines, Iowa, plastic surgeon has been named in a federal False Claims Act complaint alleging he submitted fraudulent invoices to Medicare to inflate reimbursements for skin substitute products used to treat wounds following Mohs surgery, according June 23…
California Attorney General Rob Bonta has reached a $4.5 million settlement with Bay Area-based telehealth company Carbon Health Technologies and its co-founder and former CEO Eren Bali over allegations of violating California’s prohibition on the corporate practice of medicine and…
Prior authorization reform is moving on multiple fronts in 2026 — through Congress, state capitals, federal courtrooms and the exam rooms where physicians spend an average of 13 hours per week on PA paperwork alone. Here are 10 recent updates…
For physicians weighing a career move, state income tax is often the deciding variable, and in high-earning specialties, the wrong state can cost more than $50,000 a year. Here are five things to know: 2. According to a report from…