Here are five numbers for ASC leaders and physicians to know about prior authorization in 2024:

Oroville (Calif.) Hospital agreed to pay $10.25 million to resolve false claims allegations stemming from medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme and erroneous diagnosis code use.

Here are 26 moves by payers for ASC leaders and physicians to know in 2024:

Here are three recent updates on prior authorization for ASC physicians and leaders to know:

On Nov. 26, CMS proposed reforms to the Medicare Advantage and Part D programs for contract year 2026, including changes to prior authorization and GLP-1 coverage. 

ASCs are facing a trifecta of pay issues — anesthesia stipends, rising expenses and stagnant reimbursements. 

Many ASCs have voiced support for site neutrality, which would create parity between ASC and hospital reimbursements, yet has been met with pushback from hospitals. 

The ASC market will likely see significant growth into the next several years, but many ASC leaders and physicians continue to feel tied down by arduous administrative burdens. 

ASC software leader Surgical Information Systems has acquired ASC-focused, revenue cycle management, transcription and coding services provider Surgical Notes. 

While many physician specialties have seen salary increases in recent years, those increases are being felt less by physicians. 

During an interactive session at Becker's 30th Annual meeting: The Business & Operations of ASCs, Dan Parsons, Co-Founder and Chief Experience Officer at Thoughtful AI, and Kathrynne Johns, Chief Financial Officer at Allegiance Mobile Health, discussed the implementation and benefits of AI in revenue cycle management.

In an interactive session at Becker's 30th Annual Meeting: The Business & Operations of ASCs, two leaders from Zotec Partners — David Law, chief client officer, and Sarah Mountford, vice president of client relationships — led an engaging session on revenue cycle-focused strategies that address patient care and satisfaction challenges at ASCs.

The future of the Stark law is uncertain following a recent district court decision that a False Claims Act lawsuit against South Charleston, W.Va.-based Thomas Health System could not be resolved without further briefings on the U.S. Supreme Court's recent reversal of the Chevron deference doctrine.

All of healthcare has struggled with declining reimbursements, patient care issues and administrative burdens associated with Medicare Advantage plans. 

Physician frustration is growing as prior authorization and other payer obstacles lead to increased retrospective payment denial. 

Anti-Kickback Statute and the False Claims Act enforcement is entering a new era — turning away from enforcement of COVID-10 pandemic-era fraud, Law.com reported Nov. 7. 

A West Virginia federal district court has dismissed a false claims lawsuit filed against Thomas Health System, citing insufficient detail in the plaintiff's allegations, according to court documents filed by Becker's. 

During President-elect Donald Trump's term, he decreased the average monthly plan premium for Medicare Advantage beneficiaries to the lowest rates MA plans had seen since 2007. 

As many ASCs voice support for site-neutral payment reform to target the growing disparity between ASCs and hospital outpatient departments, hospitals push back on legislator action advocating for such policies.

ASCs' payer issues aren't new, but many are now  increasingly challenged by complex and restrictive payment policies set by insurers.