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UnitedHealth buys Kelsey-Seybold-affiliated insurer
UnitedHealth Group, the nation's largest operator of Medicare Advantage plans, acquired Texas Medicare insurer KS Plan Administrators, the Star Tribune reported Aug. 16. -
$38M healthcare fraud scheme lands Miami physician in prison
A Miami physician has been sentenced to federal prison for committing a $38 million healthcare fraud scheme, the Justice Department reported Aug. 3. -
4 states update their noncompete laws
Four states and Washington, D.C., have recently updated their governance of agreements that prohibit employees from competing with businesses directly for a specific duration of time after their employment has ended, according to a Aug. 2 report from the National Law Review. -
Tennessee independent physician group adopts value-based care model
The Jackson (Tenn.) Clinic, one of Tennessee's largest independent physician groups, has adopted a value-based care model, the group said Aug. 2. -
CMS ups inpatient rates 4.3% for 2023; what should ASCs expect?
CMS plans to boost acute care hospital pay 4.3 percent next year, as long as the hospitals comply with quality data reporting. -
UnitedHealth in the headlines: 14 updates in 60 days
UnitedHealth Group, parent company of Optum Health and ASC management company Surgical Care Affiliates, saw a busy June and July. Here are 14 UnitedHealth updates from the last 60 days: -
Centene in the headlines: 12 updates in 60 days
Centene is one of the nation's largest health insurers by membership. Here are 12 updates from the company in the last 60 days: -
Aetna in the headlines: 5 updates in 30 days
Aetna, a CVS Health company, insurers about 39 million people. Here are five updates from the company since July 5: -
4 biggest payer moves this month
Payers are incentivizing physicians to perform procedures in low-cost settings, which means ASCs are becoming increasingly attractive. At the same time, physicians are balking at some payer moves in the last 30 days. -
Payers are pushing physicians to ASCs
Payers are incentivizing physicians to perform procedures in low-cost settings, which means ASCs are becoming increasingly attractive, according to ASC leaders. -
Elevance in the headlines: 7 updates in 30 days
Elevance Health, the insurer formerly known as Anthem, is one of the biggest payers by members with 39.9 million members. -
How CMS' physician conversion factor changed over the last 10 years
Physicians face another year of fee cuts in 2023 as Medicare proposes to reduce the conversion factor by 4.42 percent to $33.08. -
10 procedures CMS proposes moving off the inpatient-only list in 2023
Medicare is recommending removing 10 procedures from the inpatient-only list in 2023, according to its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed rule, released July 15. -
Payers updating policies for ASC procedures
Four payers have updated their policy for ASC procedures since May 24: -
Cigna reconsiders latest reimbursement policy
Health insurance company Cigna is delaying the implementation of its modifier 25 policy. -
Top 5 ASC medical billing companies for 2023
Peninsula Daily News on July 11 released its picks for the top ASC medical billing companies for 2023. -
Whistleblower suit against UPMC, physician group will proceed, judge rules
A federal judge rejected the University of Pittsburgh Medical Center's bid to dismiss a whistleblower lawsuit against UPMC, its physicians group and its chair of cardiothoracic surgery, NBC affiliate WPXI reported July 7. -
CMS seeks 4.42% physician fee cut in 2023
CMS has released its Medicare physician fee schedule proposed rule for 2023, which suggests further cuts to physician pay while inflation and the cost of running an independent practice continue to rise. -
Centene in the headlines: 8 recent updates
Here are five recent updates on one of the country's largest insurers: -
Same surgery cost nearly 20 times more in HOPD than ASC in California
A retired orthopedic surgeon in Fresno, Calif., was charged nearly $4,000 more for a cataract surgery at a hospital outpatient department than his wife who received the same procedure at an ASC, Kaiser Health News reported June 27.
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