The federal government is targeting New York City-based Mount Sinai Health System's inclusion of noncompete clauses in contracts for part-time physicians in a June 18 complaint filed with the National Labor Relations Board. 

The Federal Trade Commission's ban on noncompete clauses is facing a preliminary injunction from a federal court in Texas. 

Medicare Advantage plans have garnered animosity from providers due to the restrictive approval processes for needed services.

The Justice Department charged 193 people, including 76 physicians, for their alleged roles in fraud schemes nationwide.

CMS has updated its coverage requirements for ASCs, The Joint Commission said in a June 26 news release.

As scrutiny increases on payer prior authorizations, health plans are using a new tactic to disrupt provider cash flows: post-procedure clawbacks.

Here are five numbers illustrating the effect prior authorization regulations and reform efforts have on healthcare:

Denials for outpatient care claims jumped 16% in the last three years, while inpatient care claims rose 26%, according to a May 21 report from Kodiak Solutions. 

Some leaders have become increasingly frustrated with hospital outpatient department reimbursements far outpacing ASCs, but there are efforts at the federal level to move toward site-neutral payments. 

UnitedHealthcare was delivered a win in May in its legal battle with Knoxville, Tenn.-based physician staffing company TeamHealth. 

Average payments for outpatient burn and wound services were 42.9% below costs across all payers, a May report from the American Hospital Association found.

Matt Kraemer, administrator of Northern Arizona Healthcare in Flagstaff, joined Becker's  to discuss his team's strategy in handling the obstacle of rising overhead paired with stagnating ASC reimbursements. 

ASCs nationwide are facing rising operating costs that are outpacing dwindling reimbursements.

ASCs are struggling to meet margins as procedures continue to migrate to the outpatient setting but reimbursements stagnate. 

The Federal Trade Commission voted 3-2 on April 23 to ban on noncompete clauses for most U.S. workers, and several states have since made moves to restrict noncompetes at the state level. 

A Texas physician was convicted by a federal jury for his involvement in the submission of more than $70 million in fraudulent claims to Medicare for unnecessary orthopedic braces and tests.

A Nevada physician was convicted for his role in defrauding Medicare and Medicaid of nearly $2 million.

A physician from Bloomfield Hills, Mich., was convicted of healthcare fraud and making false statements in what federal officials say was a $6.3 million Medicare fraud scheme.

Three ASC leaders joined Becker's to discuss the Medicare policies that are impeding the growth of surgery centers. 

The ASC sector has seen continued increases in CMS payment rates as procedures continue to shift to the outpatient setting, according to VMG Health's 2024 Healthcare M&A Report published May 7.