Steubenville, Ohio-based Trinity Hospital has agreed to pay $1.7 million to resolve allegations of improper financial relationships with two referring physicians in violation of the Stark law, the Justice Department said in an April 2 news release. Between 2014 and…
ASC Coding, Billing & Collections
An Atlanta-based urology practice and its physician owner have agreed to pay $14 million to resolve False Claims Act allegations of billing federal healthcare programs for medically unnecessary and unperformed procedures, the Justice Department said in an April 2 news…
A bipartisan group of lawmakers has introduced the Provider Reimbursement Stability Act, legislation aimed at modernizing the Medicare Physician Fee Schedule to address decades of declining physician reimbursement, according to a March 31 news release. The bill was introduced by…
Since March 24, the Justice Department has sentenced, accused or settled with three physicians and one durable medical equipment company owner for fraud cases. The activity comes as CMS is currently enforcing a six-month nationwide moratorium on new Medicare enrollment…
A bill introduced in Congress on March 20 would tie ASC annual payment updates directly to the hospital outpatient department fee schedule increase factor. Currently, ASC payment updates and HOPD payment updates follow different formulas, a gap that historically has…
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Two Sutter Health facilities, including an ASC, have agreed to pay $3.2 million to resolve allegations of failing to guard against the theft and diversion of controlled substances, the Justice Department said in a March 26 news release. Sutter Medical…
Despite policy efforts to increase reimbursement, spending per Medicare beneficiary on primary care physicians fell from $438 in 2017 to $420 in 2023, according to a March report published in Health Affairs. Here are 10 things to know: 1. Primary…
In December 2025, HHS, alongside the Labor and Treasury departments, proposed significant updates to healthcare price transparency rules. Comments for the proposed updates were due by March 2, 2026, and the proposals will take effect 12 months after the rules…
As outpatient surgery continues its rapid migration from hospitals, a tension is emerging: the same payers pushing care into lower-cost settings are also making it harder to deliver it. From prior authorization delays and denials to shifting federal policy and…
Practice owners receive only 35% of income from salary compared to 69.5% for employees, with 40.8% from productivity and 18.2% from practice financial performance, according to the American Medical Association’s policy research perspective published March 2029. The report analyzed physician…