A Houston-based laboratory, its former CEO and a Florida businessman have agreed to pay a combined $36.4 million to resolve False Claims Act allegations of paying kickbacks and billing Medicare and Medicaid for medically unnecessary genetic testing, the Justice Department…
ASC Coding, Billing & Collections
Auto insurance provider Geico has accused two New York physician groups and the physician who owned them of billing the insurer more than $2 million for auto-accident treatments the company says were medically unnecessary or, in many instances, never performed…
Dallas-based Tenet Healthcare executives said they are still modeling how a proposed federal rule reshaping 340B drug reimbursement and hospital outpatient facility fees could affect the company’s ASCs, according to comments on the company’s July 24 second-quarter earnings call. What…
A Yuma, Ariz., physician’s clinic has closed after Ifran Fazil, MD, was arrested and charged with four felonies, including defrauding Arizona’s Medicaid program, money laundering and possessing dangerous drugs, leaving patients scrambling for care and waiting months for medical records,…
Satellite Med, a primary care practice in the Cookeville, Tenn., area, permanently closed after 20 years of operation, with owner James Cates, MD, citing a decade of declining reimbursements and insurance company interference in clinical decision-making as the primary drivers.…
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CMS released its proposed CY 2027 Medicare Physician Fee Schedule July 14, setting up another cycle of physician pay cuts at the same time the companion CY 2027 OPPS/ASC proposed rule moves facility payment rates in the opposite direction. The…
Fort Myers, Fla.-based NeoGenomics Laboratories agreed to pay $9.8 million to resolve allegations that it violated the Anti-Kickback Statute and Stark law through two separate arrangements involving referring physicians and independent consultants, according to a settlement agreement signed July 20,…
There were several significant national-level healthcare policy updates announced, passed or developed in the last month with numerous implications for ASCs. Here are five policies ASC leaders should take note of in the last month: 1. The Senate Health, Education,…
Washington lawmakers advanced the most significant Medicare Advantage prior authorization reform in years this week. But as Congress moves to curb delays and denials for beneficiaries enrolled in private Medicare plans, CMS is simultaneously expanding prior authorization in traditional Medicare…
UnitedHealthcare’s frustration with the No Surprises Act’s arbitration system became explicit on the insurer’s second-quarter earnings call, but it is only the most recent escalation in a fight that has stalled in Congress, lost repeatedly in federal court and is…