Stark law due diligence in clinic acquisitions must include meticulous evaluation of physician ownership and compensation to prevent self-referrals, according to a blog post from attorney Aaron Hall. Here are 10 things to know about Stark law compliance and clinic…
ASC Coding, Billing & Collections
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,…
An internist in Fair Lawn, N.J., has been charged with unlawfully distributing opioids, soliciting sexual favors from patients and defrauding New Jersey Medicaid, the Justice Department said in a July 18 news release. What happened?
CMS has proposed a 3.6% increase to the 2026 Physician Fee Schedule conversion factor for non-APM participants, alongside a 3.83% boost for those in qualifying alternative payment models. For the first time, the agency would implement separate conversion factors based…
President Donald Trump has pursued increased healthcare price transparency measures so far in his term through an executive order signed in February. Now, in alignment with that policy, CMS released updated proposals for price transparency July 15. Here are five…
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On July 15, CMS proposed including a 2.6% bump to ASC payments for 2026, as well as other reforms aimed at modernizing payments and expanding healthcare access. Here are five other things to know about CMS’ new proposals for ASCs in…
CMS on July 15 issued a new proposal for the 2026 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System rule, as well as other reforms aimed at modernizing payments and expanding healthcare access. The proposed rule would affect…
The transition to value-based care may seem daunting for many healthcare leaders, especially those who operate independently and have less margin for error when it comes to implementing new systems and initiatives. Flagler Health is a technology company offering AI…
Nearly 50 health insurers, representing commercial, Medicare Advantage and managed Medicaid plans covering 257 million Americans, recently committed to simplifying and standardizing the prior authorization process, and ASC administrators are approaching the announcement with cautious optimism. These participating payers have…
Mohammed Ahmad, MD, a physician based in Avon, Ohio, pleaded guilty to submitting fraudulent orders for durable medical equipment as part of a telemedicine scheme that defrauded Medicare, the Justice Department said in a June 10 news release. What happened?