One of the largest health insurers in the nation is pushing a new out-of-network policy that could prove seriously challenging for ambulatory surgery centers (ASCs). Starting Jan. 1, 2026, Anthem will penalize hospitals, surgery centers and other facilities whenever those facilities use out-of-network providers for patients covered under Anthem commercial plans. In other words, the insurer is putting financial pressure on facilities to use only in-network resources, except in certain … [Read more...]
Legislation Blocking Medicare Cuts to Physician Reimbursement Back on the Table
Legislation to block cuts to Medicare payments for physicians is back on the table. On Jan. 31, U.S. Rep. Greg Murphy, who has a background as a medical doctor, reintroduced the bipartisan “Medicare Patient Access and Practice Stabilization Act.” A 2024 version of the bill was previously introduced in October. "Physicians in America are facing unprecedented financial viability challenges due to continued Medicare cuts,” Murphy, a Republican from North Carolina, said in a statement. “Access … [Read more...]
From Cutting Facility Fees to Banning Noncompetes: The 2024 Regulatory, Legislative Outlook for ASCs
For ambulatory surgery center (ASC) operators, staying abreast of the regulatory and legislative changes that impact daily business and patient care is crucial. And from workforce-related final rules, certificate of need (CON) developments, U.S. Centers for Medicare & Medicaid Services (CMS) changes and beyond, there has been no shortage of policy developments over the past several months. The second half of 2024 is likely to present further shifts as well, ASC industry insiders … [Read more...]