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A physician in Largo, Fla., has agreed to pay $350,000 to resolve False Claims Act allegations that he submitted fraudulent…
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By the time MLR pressure shows up in your numbers, the margin may already be locked into the quarter. The question is whether you’ll spot the signals early enough to change the outcome. Most health plans don’t recognize margin pressure…
Presented by:
- Stewart Hinrichsen, Senior Director, Value-Based Strategy, Martin's Point
- Raj Lakhanpal, Chief Executive Officer, SpectraMedix
- Sean Kelly, Senior Vice President, Growth and Business Development, SpectraMedix
Inpatient CDI has traditionally depended on disruptive retrospective queries, fragmented workflows, and clinicians revisiting the record days or weeks after discharge. What changes when context and documentation guidance arrive during the encounter, while the clinical context is still fresh? Health…
Presented by:
- TBD, TBD
Clinical reviewers open a utilization management or appeals case and spend most of it assembling evidence — hundreds of pages, several source systems and a fax queue that has outlasted every modernization plan built around it. The determination itself is…
Presented by:
- Mark Miller, Sr. VP of Insurance and Strategic Accounts, Naviant
- Jason Bui, Head of Healthcare, UiPath
Tampa, Fla.-based Pulmonary Associates of Brandon has agreed to pay $419,410 to resolve allegations that it violated the False Claims Act by submitting Medicare claims for evaluation and management services that should have been billed under a lower-paying code, according…
CMS has approved a growing list of procedures for the ASC setting in recent years, particularly in cardiology, and that shift is reshaping which specialty lines ASC operators are betting on for growth. Terry Bohlke, CEO of Nashville, Tenn.-based Keystone…
Administrative barriers, not insurance coverage, pose the biggest obstacle to bariatric surgery access in the U.S., according to a study published Aug. 29, 2026, in the journal Obesity Surgery. Researchers at the Medical University of South Carolina ran a secret…
Newark (N.J.) Beth Israel Medical Center has opened a new hybrid cardiac catheterization lab Sept. 10, expanding its capacity for complex minimally invasive heart procedures. The 730-square-foot suite, part of RWJBarnabas Health’s Heart & Vascular Service Line, pairs cardiac catheterization…
OrthoAtlanta opened its newest outpatient location in Locust Grove, Ga. The office provides orthopedic and sports medicine services, on-site imaging, same-day appointments, and physical medicine and rehabilitation services, according to a Sept. 10 news release. The location is part of…
More physician owners of ASCs are looking to partner rather than compete with hospitals, management companies or private equity firms, as rising costs and industry consolidation reshape the ASC landscape. For Terry Bohlke, that shift is the reason his new…
The ASC industry of 2036 could look considerably different from the facilities dominating the market today. As higher-acuity procedures continue migrating out of hospitals, ASC leaders expect the next decade to bring not only more complex cases into the outpatient…
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A Guide to Responsible Use of AI for Behavioral Health Settings
Presenters: Patricia Sylve, LPC-S, LCSW, Joint CommissionAndrea Leigh Yates, MBA RN CCRN, Joint Commission
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