Payers have historically treated spine surgery as a default hospital procedure, but that assumption is increasingly at odds with clinical reality. Advances in minimally invasive techniques, enhanced recovery protocols, and rigorous patient selection have made outpatient spine surgery a safe,…
Patsy Newitt
Three Florida men have been sentenced to prison for their roles in a scheme to submit nearly $7 million in fraudulent Medicare claims for medically unnecessary orthotic braces and launder more than $2.2 million in fraud proceeds, the Justice Department…
Allstate has filed three federal lawsuits against ASCs and their affiliated providers since mid-April, alleging schemes ranging from kickback arrangements and corporate practice violations to billing for procedures that were never performed. 1. Allstate sued Florida Orthopedics and Neurosurgery, which…
From a federal commission appointment to distinguished faculty awards, four anesthesiologists have recently earned notable recognition and leadership roles across academia, health systems and public service: 1. Gunisha Kaur, MD, has been recommended for appointment to the United States Commission…
Fort Myers, Fla.-based Lee Health has entered into a definitive agreement to acquire Florida Heart Associates, an independent cardiology practice serving Southwest Florida, according to a May 21 news release. Florida Heart Associates will become a Lee Health subsidiary and…
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The Business Corner is a bimonthly column by Shakeel Ahmed, MD, CEO of St. Louis-based Atlas Surgical Group. Having spent over a quarter of a century navigating the ASC industry, I have watched our business model adapt through virtually every…
Stark law was written before the internet, EHRs or AI-driven diagnostics existed. But it is still dictating how physicians can structure financial relationships in 2026, and a growing chorus of physicians, legal experts and industry groups say it is time…
Twelve years ago, Suzi Cunningham did not pay for anesthesia coverage. Today, her ASC is on its fourth provider arrangement and still searching for one that sticks. Ms. Cunningham, administrator of Advanced Ambulatory Surgery Center in Redlands, Calif., has watched…
Major health systems are shedding hospitals and funneling the proceeds into ASCs. Tenet, Ascension and Community Health Systems have collectively divested dozens of hospitals in recent years, redirecting billions toward outpatient growth. Tenet Healthcare Dallas-based Tenet Healthcare offers perhaps the…
Major payers are quietly cutting reimbursement by automatically adjusting the complexity codes on claims before payment clears. In the past year, Cigna, Aetna, Anthem and BCBS of Massachusetts have all launched or expanded automatic downcoding programs, algorithmically adjusting higher-complexity E/M…