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The payer trends defining ASCs
Two ASC leaders joined Becker's to discuss the payer trends that are affecting ASCs in the most significant ways at the moment. -
What ASCs can expect from CMS' latest prior authorization ruling
CMS has finalized prior authorization and electronic health information policy updates that are expected to create approximately $15 billion in savings over the next 10 years. -
nimble solutions appoints CEO
St. Louis-based nimble solutions, an ASC revenue cycle management company, named Kelley Blair CEO. -
Bill aims to push price transparency to ASCs
A bill that would strengthen healthcare price transparency at ASCs has been introduced in the Senate, according to a news release from Indiana Sen. Mike Braun. -
ASC suit accusing Elevance of $5.4M+ in unpaid claims revived
A circuit court has reinstated a suit from the Costa Mesa, Calif-based South Coast Specialty Surgery Center accusing Blue Cross of California, which does business as Anthem Blue Cross, of racking up more than $5.4 million in unpaid claims. -
The payer behavior physicians want changed
Five physician leaders joined Becker's to discuss the payer behavior they'd like to see changed in 2024. -
3 payer rules that took effect Jan. 1
This year is shaping up to be a big one for major U.S. payers, with several new rules going into effect. -
How ASC leaders, physicians are navigating payer relations in 2024
The ever-changing payer landscape requires leaders to be nimble in order to navigate it successfully. -
FTC noncompete ban: Where the proposal stands 1 year later
In January 2023, the Federal Trade Commission proposed a rule that would ban noncompete contracts for full-time employees and independent contractors. -
UnitedHealthcare vs. Cigna vs. Aetna: 15 updates for 2024
UnitedHealthcare Group, Cigna and CVS Health-backed insurer Aetna, three of the largest U.S. insurers by membership, each had an eventful 2023. -
The Congress members fighting CMS' 2024 pay cuts
Nearly 200 members of Congress have co-signed a bipartisan letter urging House and Senate leaders to pass legislation addressing 2024's Medicare physician pay cuts, according to a Jan. 4 report from the American Medical Association. -
Cigna in 'advanced talks' to sell Medicare Advantage business
Cigna is reportedly in "advanced talks" to sell its Medicare Advantage business to Chicago-based health insurer Health Care Service Corp., according to a Jan. 3 report from The Wall Street Journal. -
5 numbers on HOPD vs. ASC costs
The reimbursement disparity between hospital outpatient departments and ASCs is frustrating leaders as costs soar. -
3 provider fraud schemes in 5 weeks
Here are three providers who have been charged or sentenced for their alleged roles in fraud schemes that Becker's has reported on since Dec. 5: -
Sarasota Memorial, UnitedHealthcare strike outpatient Medicare Advantage agreement
Sarasota (Fla.) Memorial Health Care System has finalized a new agreement with UnitedHealthcare allowing its urgent care, outpatient facilities and First Physicians Group healthcare providers to remain in-network with UHC's Medicare Advantage plan, according to a Dec. 29 report from the Herald-Tribune. -
New York governor vetoes noncompete ban
New York Gov. Kathy Hochul has vetoed a bill that would have banned all noncompetes, The Wall Street Journal reported Dec. 23. -
A 2024 Stark law compensation update physicians need to know
ASCs, physician groups and hospitals can provide non-monetary compensation to physicians up to an amount of $507 for the calendar year 2024, according to a Dec. 27 Lexology report. -
Cigna in the headlines: 8 updates in 60 days
Cigna, which is the fourth largest insurer in the U.S. by membership size, is considering the sale of its Medicare Advantage business. -
Springfield Clinic, ASCs back in-network with BCBS of Illinois
Springfield (Ill.) Clinic has reached a new agreement with Blue Cross Blue Shield of Illinois to bring members back in the network beginning Jan. 1, 2024. -
Stark law: Where it stands and where it's headed
Stark law, which prohibits physicians from making referrals for many Medicare-payable services to an entity if the physician or immediate family member has a financial relationship with it, has seen a year of changes and updates to policy exceptions and statutes.
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