ASC Coding, Billing & Collections

 Here are three health system and payers splits since May: 

The California legislature is considering a bill that would prohibit prior authorizations for any healthcare service if the plan or insurer approved or would have approved not less than 90 percent of the prior authorization requests a provider submitted in…

Physician groups who provide certain medical equipment, devices and supplies to their Medicare patients could be in violation of Stark law following the end of the COVID-19 public health emergency, attorneys from law firm Epstein Becker & Green wrote in…

A judge has ruled that Commonwealth Health's physician group, Commonwealth Physician Network, cannot prevent its former surgeon from working locally for Geisinger, The Times-Tribune reported Aug 21. 

Beginning Sept. 17, UnitedHealthcare Texas will begin requiring prior authorization for four medications based on new state guidelines for Texas' Medicaid program. 

Rep. Frank Pallone Jr., a Democrat from New Jersey, has announced an inquiry into the high rate of prior authorization denials by Medicaid managed care plans. 

Changes in noncompete agreements, which prohibit physicians from joining a competing practice or setting up their own within a particular distance from their previous practice for a certain period of time, are ramping up in 2023 as states amend their…

Extracapsular cataract removal without endoscopic cyclophotocoagulation is the most common procedure performed at ASCs, according to recent data from Definitive Healthcare. 

As physician and administrative shortages remain high, many health facilities are pivoting to contract labor to bolster their care teams. 

In July, CMS announced its suggested 3.34 percent conversion factor decrease in its proposed Medicare physician fee schedule for 2024. This proposal, coupled with inflation and low reimbursement rates, could put an additional strain on physicians' compensation and healthcare overall.