DOJ and HHS OIG Enforcement Actions in 2023
Even well-intentioned surgeons can trigger False Claims Act inquiries, and the Feds are watching closely; here’s how you can avoid trouble
Julie Barnes
A CMS Update on Advanced Explanation of Benefits (AEOB) Rulemaking
Is your practice ready to provide good faith estimates for the costs of the procedures you perform?
New Specialty Care Payment Model: Transforming Episode Accountability Model (TEAM)
A new CMS episode-based model for surgery — including several common orthopaedic procedures — may be promising or problematic for orthopaedic surgeons. You have an opportunity to comment.
Good or Bad or Simply Unsustainable? No Surprises Act Arbitration Process
Initial data show that the No Surprises Act’s arbitration settlements lean in favor of physicians; while practices may keep this in mind when deciding to engage with out-of-network disputes, this trend may change
CMS Innovation Center’s Integration of Specialty Care Into Value-based Care Models
It may be a good time to consider a relationship with an ACO that participates in new federal payment models
Spending Bill Increases Medicare Reimbursement Rates
Down 3.37%? Up 2.93%? Easy come, easy go. See what your practice should do in light of the recent sturm und drang with Medicare payments.
Increased Scrutiny of Private Equity and Consolidation in Health Care
The federal government wants to know: How has health care consolidation impacted your practice?