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. 

CVS Health-owned health insurance provider Aetna has announced its 2024 Medicare products, the largest Medicare offering in its history. 

Around 6 in 10 adults have experienced problems with their health insurance, according to a Sept. 29 report from KFF, with several problems linked to prior authorization delays and denials from payers. 

Here are three physicians' thoughts on noncompetes:

Here are three big payer moves disrupting the ASC industry: 

The legal landscape is growing increasingly hostile to noncompete agreements, according to a Sept. 27 article in JDSupra by law firm Dorsey & Whitney. 

In the intricate web of the modern healthcare industry, the term "out-of-network" has become somewhat synonymous with confusion and uncertainty for both patients and providers.

The ASC industry is constantly evolving, and one of the major players in its evolution is CMS. 

This year, eight major U.S. health systems have canceled their Medicare Advantage contracts, often citing low reimbursement rates and prior authorization hassles. 

CMS settled a record number of 104 Stark law self disclosures in 2022, totaling more than $9.2 million, according to a Sept. 18 JDSupra report from law firm McGuireWoods. 

CMS recently passed a Stark law update that will allow hospitals and healthcare providers to improve mental health services for physicians.

Serving over 1,100 surgical clients nationwide for over twenty years, nimble solutions has unique insight into the claim denial reasons for ambulatory surgery centers (ASCs). Our business intelligence and analysis team recently conducted a comprehensive study to explore the most common denial reasons for ASCs and the root cause of those denials. The study analyzed clearinghouse data from ASCs nationwide for the year-to-date period ended June 2023.

Four physicians joined Becker's to discuss the Stark law trends they are eyeing. 

The cost of common medical procedures are as much as 58 percent more expensive when performed in hospital outpatient departments compared with ASCs or physicians' offices, according to an analysis by the Blue Cross Blue Shield Association. 

Value-based care has become one of the most-used buzzwords in healthcare. But how does it apply to ASCs? 

Here are eight updates on six of the U.S.' largest payers that ASC leaders should know:

As the ASC landscape continues to evolve, so does the challenge of claim denials. As part of our commitment to providing practical solutions for our clients, nimble’s analytics team conducts on-going studies to address the most common claim denial reasons.

As part of its 2022 end-of-the-year spending package, Congress passed the NOPAIN Act, set to take effect in 2025, that will set up a separate Medicare payment for certain non-opioid pain management approaches in outpatient and ASC settings, according to a Sept. 11 report from the Baltimore Sun.