Physician group practices and hospitals that participated in the Medicare Bundled Payments for Care Improvement – Advanced model experienced a significant reduction in spending, according to a study published July 25 in JAMA Health Forum. The study, which included a…
ASC Coding, Billing & Collections
As reimbursement pressures mount and payer strategies evolve, ASC leaders are keeping a close eye on how these changes may impact operations, revenue and patient care. From value-based care initiatives to reimbursement cuts and claim denials, two ASC leaders joined…
Insurers are deploying a growing arsenal of strategies to delay, deny or reduce reimbursements, creating major operational and financial strain for ASCs. Becker’s spoke with two ASC leaders about the most common payer strategies they’re seeing and how the resultant…
UnitedHealth Group is complying with criminal and civil investigations by the Justice Department regarding its Medicare Advantage business, according to a July 24 regulatory filing by the company. Here are 7 things to know about the investigation into the nation’s…
An ASC in Liverpool, N.Y., has reached a settlement with the U.S. Department of Health and Human Services Office for Civil Rights over alleged violations of the HIPAA Security and Breach Notification Rules, according to a July 23 HHS news…
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Becker’s has reported on four physician fraud cases since July 21: 1. Harrisburg-based Eye Consultants of Pennsylvania has agreed to pay $790,000 to resolve allegations that it submitted false claims to Medicare. Between Sept. 1, 2018, and April 7, 2025,…
CMS released the 2026 proposed payment rule for hospital outpatient departments and ASCs on July 15. The proposal included the addition of 276 procedures to the Covered Procedures List for ASCs. It also proposed phasing out the inpatient-only list, beginning…
Despite CMS’ most recently proposed boost to physician payments, years of reimbursement declines have pushed some physicians to stop accepting Medicare patients entirely. Health policy research group KFF recently released data showing the overall number and percentage of physicians who…
Harrisburg-based Eye Consultants of Pennsylvania has agreed to pay $790,000 to settle allegations of submitting false claims, the Justice Department announced July 22. What happened?
A physician in Kingsport, Tenn., has been accused of healthcare benefit fraud, making false statements and unlawfully distributing controlled substances, WJHL 11 reported July 21. What happened?