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Centene in the headlines: 9 updates in 30 days
From the canceling of nearly $2 billion in projects to a terminated contract with Tenet, here are nine Centene updates published by Becker's since Aug. 1. -
Former NBA player orchestrated $5M health insurance fraud
Former NBA player Terrence Williams, the 11th overall pick in the 2009 NBA draft, pleaded guilty to healthcare and wire fraud conspiracy charges and aggravated identity theft, the Justice Department said Aug. 26. -
ASC sues UnitedHealthcare for alleged ERISA violations
Taylor Theunissen, MD, and Metairie, La.-based Sadeghi Center for Plastic Surgery filed a lawsuit against UnitedHealthcare, alleging the insurer failed to pay preathorized claims in violation of the Employee Retirement Income Security Act, according to Law Street Media. -
No Surprises Act final rules: What ASCs need to know
The HHS and Labor Department Aug. 19 issued the final rules for the No Surprises Act. -
Optical devicemaker settles kickback allegations for $16.4M
Optical devicemaker Essilor is paying $16.4 million to settle allegations that it paid kickbacks and violated the False Claims Act, the Justice Department said Aug. 23. -
35% of physicians see increase in compensation tied to quality
The trend toward value-based care models in recent years has been followed by a push for quality performance metrics. -
Value-based contract revenue as percentage of total revenue in 3 categories
The Medical Group Management Association recently released its report, "Patient Access and Value-based Outcomes Amid the Great Attrition," which details the revenue driven from value-based contracts in healthcare by specialty. -
ASC-payer negotiations: 1 CEO's advice for securing the right contracts
Negotiating contracts with commercial payers is one of the most challenging and fatiguing aspects of an ASC administrator's role. But there are core strategies administrators should consider when sitting at the table with insurers, including arming oneself with cost and outcomes data, understanding the market and fostering good relationships with negotiators. -
UnitedHealth vs. Anthem vs. Cigna in Q2
Payers UnitedHealth, Anthem and Cigna are some of the largest insurers by membership. -
Prior authorization in 2022: 13 updates
Healthcare providers have been pushing for prior authorization reform this year, and many states are passing legislation to remove prior authorization requirements. -
'Depersonalization' of medicine likely to continue amid CMS physician pay cuts, physician says
CMS' plan to cut physician pay by 4.42 percent in its Medicare physician fee schedule proposal is leaving many physicians worried about healthcare becoming more impersonal. -
Value-based care in 2022: 15 updates
ASCs are looking to value-based care as the industry pivots to support bundled payment models. -
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:
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