Since CMS implemented a six-month nationwide moratorium on new Medicare enrollment for certain durable medical equipment suppliers, the Justice Department has announced at least four settlements and sentences tied to DME fraud schemes. CMS said it stopped more than $1.5…
Author: Patsy Newitt
While independent physician groups have been busy expanding into the ASC space in recent years, operational gaps have emerged and gone largely unaddressed. According to Pelto Health Partners’ fractional CEO, Rachel Uzlik, independent ASCs often leave savings and operational efficiencies…
Physician-owned Pelto Health Partners has launched an ASC platform initiative, extending its private practice model into the surgery center space and aiming to give physician owners more options without forcing them into a traditional management service organization structure. Minneapolis-based Pelto…
Winchester, Ky.-based Centerpoint Health acquired the physician practice of Suzanne Pica, MD, and David Andreas, MD, integrating it into its affiliated medical group, Centerpoint Medical Group, according to a March 10 news release. As part of the integration, the practice…
Brentwood, Tenn.-based Surgery Partners recruited about 700 physicians in 2025, according to a March 4 earnings call transcript from Seeking Alpha. The company reported $3.3 billion in revenue in 2025 and $526 million in adjusted EBITDA. Here are six more…
Advertisement
In its 2026 Physician Fee Schedule, CMS finalized a mandatory payment model that will begin Jan. 1, 2027, and hold certain outpatient specialists financially accountable for how they manage chronic conditions such as heart failure and low back pain. The…
The Department of Justice is preparing to investigate a growing number of False Claims Act cases involving skin substitutes, with more cases expected, according to a Feb. 6 blog post from law firm Akin, citing remarks from Deputy Assistant Attorney…
As labor costs climb and federal reimbursement lags, anesthesia coverage has become one of the fastest-growing financial pressures on ASCs. ASC leaders told Becker’s the gap between what anesthesia services cost and what payers reimburse has widened significantly. Many ASCs…
A Texas man was sentenced to 90 months in prison for his role in a $59.9 million scheme involving medically unnecessary durable medical equipment billed to Medicare, according to a March 9 news release from the Justice Department. The move…
Healthcare consolidation continues to reshape the physician landscape, with hospitals and large networks investing hundreds of millions of dollars to bring independent practices under their umbrellas. Recent deals, including a $111 million acquisition in South Carolina and a $29 million…