CMS has sent about 342 warning notices to hospitals found noncompliant with price transparency regulations since Jan. 1, 2021, when the rule went into effect. 

Blue Cross Blue Shield of Texas customers no longer have in-network access to physicians and facilities of Houston-based health system Memorial Hermann, The Examiner reported March 3.

Seventy-nine percent of medical groups say that payer prior authorization requirements increased in the last year, according to a poll conducted by Medical Group Management Association March 1.

Variations of colonoscopies make up three of the 10 most common procedures performed at an ASC, according to data company Definitive Healthcare.

Cigna, one of the country's largest payers, has named two executives in the last month. 

Health insurer chief executives earn millions of dollars each year while their companies narrow networks and lower pay rates for physicians and ASCs.

UnitedHealth Group has decided to stop mailing prior authorization and clinical decisions to providers on paper.

Health insurers have made several moves to grow their networks, become more efficient and institute new policies over the last few weeks, and one major company was hit with a lawsuit by the Justice Department.

UnitedHealth Group, parent company of ASC management company United Surgical Partners International, reported sizable year-over-year growth in 2021. 

Brockton Urology Clinic in Boston will pay thousands of dollars to settle allegations it accepted kickbacks from a hospital for services never provided, according to the Justice Department.

National Medical Billing Services, a healthcare revenue cycle management company focused on ASCs, closed its second transaction of the year.

Gastroenterology claims the highest case mix, on average, among the nation's 6,028 ASCs, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022.

Orthopedics tops the pack for ASC revenue per case, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. The specialty was only the fourth most-represented among ASC cases, however.

From the dismissal of the inpatient-only list to the removal of procedures from the ASC-payable list, CMS plays a massive role in the success of an ASC.  

Thirty-four percent of physicians reported that delays in processing a prior authorization led to a serious adverse event for a patient in their care, according to a recent survey from the American Medical Association. 

UnitedHealthcare now requires members to obtain prior authorization before undergoing physical and occupational therapy at multidisciplinary offices and outpatient hospitals in four states.

Chicago-based insurance provider UnitedHealthcare has ended its requirement in most plans for providers to submit an observation notification after a patient is discharged home, the company said Feb. 10.

Payers UnitedHealthcare, Cigna and Anthem reported the largest year-end revenue in 2021. 

Two Laredo, Texas-based physicians were among 10 indicted in a $300 million healthcare fraud scheme Feb. 10, according to the Justice Department.

The No Surprises Act, the federal law requiring ASCs and physician practices to provide cost estimates to self-pay patients, went into effect Jan. 1.