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…
Author: Patsy Newitt
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…
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CMS’ decision to phase out the inpatient-only list over three years is expected to accelerate the migration of procedures to outpatient settings, particularly ASCs. The policy would eliminate a longstanding Medicare rule that restricted reimbursement for certain complex procedures to…
Kartik Bhatia of Geneva, Ill., was sentenced to two years in prison for a scheme that defrauded Medicare of more than $2 million by submitting claims for medically unnecessary durable medical equipment, according to a March 6 news release from…
Downeast OB-GYN in Bangor, Maine, which opened in 1994, will close July 2, the practice announced in a March 6 Facebook post . In the post, owner Christopher Ramset, MD, said the primary reason for the closure was an inability…
A Kansas anesthesiologist was sentenced to three years in prison for a telemarketing scheme that billed Medicare for medically unnecessary orthotic braces, according to a March 6 news release from the Justice Department. The move comes after CMS implemented a…
By 2036, the U.S. is projected to have 39,600 cardiology physicians available to meet a demand of 46,600, leaving a shortfall of about 7,000 physicians nationwide, according to projections from the Department of Health and Human Services’ Health Resources and…