CMS settled a record-breaking $9.29 million in Stark law voluntary self-referral disclosure settlements in 2022, according to recent CMS data.

Morgantown-based West Virginia University Medicine has launched an in-house health insurance services company, Peak Health, which has been serving WVU Medicine employees. Now, the system is expanding its offerings to Medicare-eligible patients throughout the state, according to an Oct. 19 report from The Weirton Daily Times. 

HHS' Office of the Inspector General has confirmed broad protection of employee safe harbor under anti-kickback laws in a recent ruling involving physician ownership of an ASC, according to an Oct. 17 article in JDSupra written by law firm Sheppard Mullin. 

CMS is floating the implementation of a separate add-on payment for healthcare common procedure coding system code G2211 in its 2023 Medicare Physician Fee Schedule, according to an Oct. 13 report in JDSupra written by law firm Reed Smith. 

From negotiating new contracts to expanding plans, here are five moves from these three major payers since Oct. 2: 

Health insurer Cigna has been ordered to pay over $172 million to settle claims that it submitted false diagnosis codes to Medicare Advantage, according to an Oct. 2 report from CBS News.

Cigna healthcare is expanding its Medicare Advantage plans to patients in Nevada for the first time, launching in two counties in the Las Vegas area. 

This year, the U.S. Office of the Inspector General conducted an audit of insurer Aetna's Medicare Advantage program to ensure that selected diagnosis codes Aetna submitted to CMS for use in CMS' risk adjustment program complied with federal requirements. 

Fredericksburg, Va.-based Mary Washington Healthcare will no longer offer Medicare Advantage plans beginning next year, citing rising costs, operational challenges and the impact of COVID-19, according to an Oct. 11 report from The Free Lance-Star.

While PPOs are generally considered beneficial for providers due to the promise of a broader patient base, silent PPOs bring forth an array of hidden pitfalls and challenges they pose for healthcare providers.

Louisville, Ky.-based Baptist Health could be going out of network with UnitedHealthcare for certain Medicare enrollees after its contract with the payer expires on Jan. 1, according to an Oct. 6 report from WDRB.

Cleveland, Ohio-based University Hospitals has launched a co-branded Medicare Advantage Plan for individuals in three Ohio counties in partnership with PrimeTime Health Plan. 

UnitedHealthcare is one of the country's largest payers.

ASCs are not the only entities that struggle to strike deals with payers. 

Cardiology is one of the fastest-growing ambulatory surgery center (ASC) specialties, and we're seeing the development of new cardiovascular ASCs nationally. Fueling the rise of cardiology in the ASC industry is the addition of different types of cardiovascular procedures to the ASC Covered Procedure List (CPL) over the past several years.

Almost 30 million U.S. workers have noncompete provisions in their contract, according to an Oct. 4 report from U.S. News & World Report.

Maryland employers are barred from noncompete provisions for certain employees, according to an Oct. 3 article about state and local employment developments published in JDSupra and written by law firm Faegre Drinker Biddle & Reath. 

Understanding physician arrangements and Stark law is critical to ensure patient care while complying with legal policy, according to an Oct. 4 article published in JDSupra and written by the Health Care Compliance Association. 

Here are five leaders' thoughts on three recent CMS moves shaping the industry:

Young physicians are participating in fee-for-service models more than other methods of payment, according to a report published by Medscape.