The North Carolina Supreme Court's recent ruling on a physician's certificate-of-need lawsuit could lead to an unraveling of the policy, NBC affiliate WRAL reported Oct. 18. 

Phoenix-based Fortitude Surgery Center has filed a lawsuit against Aetna, alleging violations of federal retirement income policy by denying claims for medically necessary services, according to court documents obtained by Becker's. 

Revenue cycle outsourcing is surging in popularity among ASCs. Two of the main reasons why: It's become more difficult to run a successful ASC business office, and it's become much easier for a business office's performance to fall off and then struggle to recover.

Here's are recent updates to the No Surprises Act and changes expected in 2025: 

MHH Healthcare, a San Juan, Puerto Rico-based MA insurer, holds the highest average star rating out of the 15 largest Medicare Advantage insurers by membership, according to an analysis from Chartis. 

CMS has been phasing in new hospital price transparency requirements throughout 2024, with more changes set to take effect Jan. 1, 2025.

Beginning in January 2025, the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems will be mandatory for ASCs and HOPDs. The new survey from CMS will gauge patient satisfaction in Medicare-certified HOPDs and ASCs, focusing on communication, care quality and facility conditions, VMG Health reported Oct. 14. 

In a new survey, Medscape laid out how much self-employed and employed physicians are paying for malpractice premiums annually and how they feel about it.  

ASCs, physicians and hospitals alike have struggled with declining reimbursements, patient care issues and administrative burdens associated with Medicare Advantage plans — pushing some to drop the program entirely. 

Physicians are facing increasing economic challenges that threaten their autonomy as healthcare consolidations.

About 40% of physicians believe practitioners have no obligation to take on Medicaid patients, according to the second part of Medscape's "Hot Topics in the Medical Profession Report 2024," published Oct. 9. 

From Stark law violations to the overturning legal precedents, several significant legal developments occurred within healthcare fraud enforcement in the third quarter of 2024. 

A federal judge in Florida has dismissed a whistleblower lawsuit accusing a medical practice of inflating Medicare reimbursements, citing constitutional concerns over the False Claims Act's qui tam provisions, law.com reported Oct. 4. 

Denials of claims are increasing, along with the administrative burden of managing them, according to Experian Health's "2024 State of Claims" survey. 

Migrating procedures to the ASC setting has the potential to save patients, payers and healthcare money.

Stark law has evolved into a complex framework that continues to challenge physicians, and as regulatory changes and enforcement actions escalate, leaders are grappling with how best to comply with these laws. 

Nearly 75% of providers report an increase in claim denials, a 31% jump since 2022, according to the Experian Health's "2024 State of Claims" survey. 

The future of Stark law is "clouded by uncertainty" after a district court ruled that a false claims lawsuit filed against Thomas Health System cannot be resolved without parties' briefs on the U.S. Supreme Court's recent overturning of the Chevron deference, according to a September blog post from law firm Hooper Lundy. 

The U.S. House Sept. 23 has unanimously passed a bill allowing mail delivery of prescription drugs to Medicare patients.

On Sept. 24, CMS issued a final ruling to address "significant, anomalous and highly suspect" billing activity on the Medicare Shared Savings program to mitigate financial impacts for Accountable Care Organizations.