News
Kaiser Permanente, Renown Health finalize Nevada joint venture
11+ hour, 30+ min ago (214+ words) Oakland, Calif.-based Kaiser Permanente and Reno, Nev.-based Renown Health have finalized a joint venture to operate a health plan and outpatient care delivery system in northern Nevada. Under the agreement, Hometown Health, previously owned by Renown Health, is…...
Kaiser's $556M Medicare Advantage whistleblower lawsuit: 10 things to know
6+ day, 23+ hour ago (558+ words) In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting unsupported diagnosis codes to Medicare Advantage. The government alleged the scheme…...
ASCs vs. rising payer denials, audits and delays
1+ week, 4+ day ago (468+ words) Denials, audits and delayed payments are accelerating across ASC, and leaders say payer behavior has become more aggressive, automated and less collaborative over the past year." Five ASC executives joined Becker's to discuss how they're adapting, from tightening documentation and…...
Medicare pay per ASC patient over the last 5 years
2+ week, 1+ hour ago (112+ words) Fee-for-service Medicare payments per beneficiary receiving care at ASCs rose sharply over the past year, increasing 13.1% from 2023 to 2024, according to MedPAC Medicare carrier claims data published Jan. 15. Here are fee-for-service Medicare payments per beneficiary receiving ASC services from 2019 to 2024: Denials,…...
UAB Medicine acquires independent multispecialty practice
4+ week, 1+ day ago (190+ words) The deal, finalized Jan. 1, allows Southview to continue delivering high-quality care while gaining the stability and resources of an academic health system, according to a Jan. 5 news release from UAB. Southview Medical Group, which is also based in Birmingham, has…...
Arizona Cigna enrollees may lose access to Tenet sites amid dispute
1+ mon, 2+ week ago (212+ words) More than 400,000 Cigna Healthcare members in Arizona could lose access to Tenet Healthcare's Phoenix-based Abrazo Health network if the two organizations fail to reach a new agreement by the end of the year, the Phoenix Business Journal reported Dec. 12. The…...
How ASC leaders view bundled payments in 2026
2+ mon, 1+ week ago (150+ words) As bundled payments, an alternative to fee-for-service for surgery, become more popular, most ASCs report minimal utilization of the model. For its "ASC Leader Expectations for 2026" survey, VMG Health asked 97 leaders what portion of their net patient service revenue currently…...
3 payer moves disrupting ASCs, physicians
2+ mon, 2+ week ago (444+ words) Here are three recent policy decisions by public and private insurers that are disrupting ASCs and physician practices: 1. Several physician associations are urging Elevance Health to abandon its new policy that penalizes hospitals and contracted facilities for using care providers…...
Physicians urge Anthem to drop policy penalizing out-of-network providers
2+ mon, 2+ week ago (324+ words) Several physician associations are urging Elevance Health to abandon its new policy that penalizes hospitals and contracted facilities for using care providers who are not in-network with its Anthem Blue Cross Blue Shield commercial plans in 11 states. Under the policy,…...
Millennium Physician Group partners with veriMed Health Group
2+ mon, 2+ week ago (117+ words) Fort Myers, Fla.-Millennium Physician Group has partnered with veriMED and verMED Health Group, South Florida Hospital News reported Nov. 14." The partnership will expand Millennium's reach across Central and Western Florida. It aims to strengthen its "full-risk Medicare Advantage and…...