It is often said that the operating room minute is the most expensive unit of time in healthcare — but that doesn’t mean it’s necessarily central to ASC profit margins. Michael Verdon, DO, a neurosurgeon and chief medical officer at…
ASC Coding, Billing & Collections
Mark Cuban disrupted pharmaceutical pricing in 2022 with Cost Plus Drugs, a public benefit corporation that charges a flat 15% markup on generics and posts its full price list publicly, bypassing pharmacy benefit managers and intermediaries entirely. Four years later,…
The push for site-neutral payments — reimbursing providers at the same rate regardless of the site-of-service— has picked up momentum in Congress and remains a key point of advocacy for ASC leaders in Washington. At Becker’s 23rd annual Spine, Orthopedic…
An Ohio physician has been sentenced to five years of probation for her role in a healthcare fraud conspiracy that fraudulently billed Medicare for more than $1.8 million in medically unnecessary durable medical equipment and genetic testing, the Justice Department…
The Medicare Payment Advisory Commission’s June 2026 report to Congress focuses on broader Medicare payment incentives, enrollment complexity, improper payments and Medicare Advantage’s effects on provider finances. In the report, MedPac continues to build its argument that fee-for-service Medicare creates…
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Independence Blue Cross and Highmark have implemented new policies aimed at reducing healthcare spending by steering certain outpatient procedures from hospitals to lower-cost ASCs, according to a June 14 report by The Philadelphia Inquirer. Philadelphia-based Independence Blue Cross launched its…
Medicare Advantage now covers more than half of all Medicare beneficiaries, and it is built around financial incentives to reduce costs, but it uses ASCs at virtually the same rate as traditional fee-for-service Medicare. That finding, drawn from a KNG…
The Ambulatory Surgery Center Association filed comments June 9 with CMS pushing back against potential inclusion of ASCs in the Transforming Episode Accountability Model, arguing the program is poorly structured for the ASC setting and could slow the migration of…
A San Francisco-based telehealth company and its chief medical officer have agreed to pay $3.325 million to resolve False Claims Act allegations of billing federal healthcare programs and California insurers under the names of providers who did not actually render…
The gap between what ASCs are paid and what hospital outpatient departments receive for identical procedures has become one of the defining financial pressures in outpatient surgery. Here are five numbers that capture the scope of the problem. $56.322 vs.…