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…
ASC Coding, Billing & Collections
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…
Two urologists have agreed to pay a combined $2.2 million to resolve False Claims Act allegations of performing medically unnecessary surgical procedures involving an implantable neurostimulation device and billing Medicare for the unnecessary procedures, the Justice Department said in a…
Stark law violations often surface through claims data, whistleblowers and audit trails, sometimes years after the arrangement in question was put in place. Here are four things physicians need to know: 1. Strict liability means intent doesn’t matter. The Stark…
A Fort Worth, Texas cardiologist has been charged in an $89 million healthcare fraud scheme involving medically unnecessary cardiovascular screening tests on college student athletes, including one who died of sudden cardiac arrest approximately 24 days after the physician allegedly…
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When Mike Verdon, MD, a neurosurgeon in Dayton, Ohio, first heard about the Ambulatory Specialty Model, his reaction was alarm — not for himself, but for the colleagues he looked up on the CMS participant list. “I looked, I’m not…
Total clinical compensation rose 4.3% in 2025, but about half of that growth is being funded by providers doing more work, not by gains in reimbursement, according to the AMGA 2026 Medical Group Compensation and Productivity Survey shared with Becker’s. …
A Tennessee clinic owner and physician has been charged with prescribing more than 5.6 million pills and doses of controlled substances without a legitimate medical purpose over more than eight years, the Justice Department said in a June 23 news…
The decision to leave hospital employment for independent practice is not just a financial calculation; for many physicians, it is a geographic one. Ahmed Hasan, MD, president of Lehigh (Pa.) Gastroenterology Associates, knows physicians who recently went independent and are…
The Justice Department has announced its 2026 National Health Care Fraud Takedown, charging 455 defendants, including 90 physicians and other licensed medical professionals, in schemes involving more than $6.5 billion in false claims, the department said in a June 23…