ASC Coding, Billing & Collections

Suburban Chicago physician John Greager, MD, and his ASC will pay more than $757,000 to settle allegations he submitted fraudulent claims to Medicare and the Federal Employees Health Benefits Program.  

A bipartisan Congressional majority is putting pressure on CMS to finalize a federal regulation that would overhaul prior authorization within Medicare Advantage, according to a July 24 report from the American Medical Association.

Here are four Stark law changes Becker's has reported on since Feb. 15:

Josh Troast, director of ambulatory surgical services for Muskegon (Mich.) Surgical Associates, joined Becker's to discuss what ASCs need to thrive in the next five years. 

Health Care Service Corp., a health plan operator for 18 million members across Illinois, Montana, New Mexico, Oklahoma and Texas, is integrating artificial intelligence and augmented intelligence to reform its prior authorization process. 

CMS pitched a 2.8 percent average rate increase for ASCs next year, and many leaders feel the move isn't enough to offset increasing costs. 

Physician pay is struggling to keep up with inflation, declining reimbursement and Medicare pay cuts.

In the 2024 hospital outpatient prospective payment system, CMS pitched a 2.8 percent average rate increase for ASCs next year.

CMS plans to add only 26 dental surgical codes to the ASC payable list next year, according to the 2024 Hospital Outpatient Prospective Payment System proposal released July 13. 

Here are 16 physician kickback suits Becker's  has reported on in 2023 that totaled more than $180 million in either restitution or cost of the fraud scheme: