The American Hospital Association, which represents 5,000 member hospitals, health systems and other healthcare organizations, has submitted a letter to CMS commenting on its proposed hospital outpatient prospective payment system and ambulatory surgical center payment system rules for calendar year 2024. 

On average, physician specialists bill $3.8 million annually to commercial payers, but some specialties, including orthopedic surgery and urology, bill well over that amount, according to data from AMN Healthcare's 2023 "Review of Physician and Advanced Practitioner Recruiting Incentives" report.

Blue Cross Blue Shield of Michigan has announced a new effort to reduce prior authorization requirements by 20 percent in order to improve healthcare quality and access while reducing administrative tasks. 

From repealing existing prior authorization requirements to adding new ones, here are four states tackling the prior authorization system this year. 

Physicians are facing rising prior authorization requirements and increasing denials, and some leaders say it is taking away their ability to make decisions. 

Three major payers have cut prior authorization requirements in August:

Here are three Stark law updates that may affect ASCs: 

UnitedHealthcare is the largest insurer in the U.S. by market share, according to a July 2023 report from Value Penguin. 

On Sept. 1, UnitedHealthcare will begin its two-phased approach to eliminating prior authorization requirements. 

Cigna, the fourth-largest insurer in the U.S. by membership, has received accolades — and scrutiny — in the last two months. 

The Biden administration has announced the first 10 medications that will be subject to price negotiations with Medicare under the Inflation Reduction Act. 

The Biden administration has revealed the first 10 medications that will be subject to price negotiations between manufacturers and Medicare under the Inflation Reduction Act, according to an Aug. 29 report from CNBC.

The American Hospital Association, which represents 5,000 member hospitals, 270,000 affiliated physicians and 2 million nurses and caregivers, has authored a letter in support of proposed House Resolution 4968, the GOLD Card Act of 2023. 

CMS has proposed a new Medicare physician payment schedule for 2024, addressing topics from anesthesia conversion rates to merit-based payment systems. 

UnitedHealthcare is the largest insurer in the U.S., according to a July 2023 report from Value Penguin. 

Oncologist William Harwin, MD, former president and managing partner of Fort Myers-based Florida Cancer Specialists & Research Institute, has pleaded guilty in a conspiracy to allocate oncology treatments for cancer patients. 

Cigna Healthcare is removing nearly 25 percent of medical services from prior authorization requirements, cutting more than 600 codes. 

 Here are three health system and payers splits since May: 

The California legislature is considering a bill that would prohibit prior authorizations for any healthcare service if the plan or insurer approved or would have approved not less than 90 percent of the prior authorization requests a provider submitted in the most recent completed one-year contracted period.

Physician groups who provide certain medical equipment, devices and supplies to their Medicare patients could be in violation of Stark law following the end of the COVID-19 public health emergency, attorneys from law firm Epstein Becker & Green wrote in an Aug. 14 JDSupra article.