Tag: CMS

Private equity bets big on outpatient cardiology as CMS boosts reimbursements

Editor's Note Private equity firms are accelerating their push into outpatient cardiology, lured by reimbursement trends and a fragmented market but shadowed by concerns about patient outcomes and financial motives, Modern Healthcare October 16 reports. Investor activity in cardiology has surged alongside the Centers for Medicare & Medicaid Services (CMS)…

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By: Tarsilla Moura
October 22, 2025
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AI-driven CMS pilot model could slow ASC care despite fraud-fighting goals

Editor's Note The Centers for Medicare & Medicaid Services (CMS) is enlisting artificial intelligence (AI) to combat wasteful spending, but ambulatory surgery centers (ASCs) warn the plan could slow care and increase administrative strain, Ambulatory Surgery Center News October 20 reports. The agency’s new Wasteful and Inappropriate Service Reduction (WISeR)…

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By: Tarsilla Moura
October 22, 2025
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Telehealth in limbo: Providers split on continuing Medicare services during shutdown

Editor's Note Telehealth providers are divided over whether to continue serving Medicare patients after reimbursement expired alongside the federal government shutdown, Modern Healthcare October 9 reports. The impasse has forced organizations to weigh patient access against financial risk, with many issuing advance beneficiary notices warning patients they may be responsible…

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By: Tarsilla Moura
October 15, 2025
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Spine surgeon shortage deepens as consolidation, site shifts reshape ASC markets

Editor's Note Hiring for spinal procedures are tightening and consolidation is accelerating, reshaping where and how ambulatory surgery centers (ASCs) secure talent, Becker’s Spine Review October 3 reports. A mounting orthopedic shortage exceeding 5,000 by year-end is making spine one of the hardest specialties to recruit, with timelines stretching and…

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By: Tarsilla Moura
October 8, 2025
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CMS proposal to end inpatient only list draws strong industry response

Editor's Note The plan to eliminate the Medicare Inpatient-Only (IPO) List and expand the Ambulatory Surgery Center Covered Procedures List (ASC-CPL) from the Centers for Medicare & Medicaid Services (CMS) has generated widespread reaction, with more than 3,900 comments submitted during the official feedback period, Ambulatory Surgery Center News September…

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By: Tarsilla Moura
September 22, 2025
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Hospital complaints surge as oversight gaps leave patients frustrated

Editor's Note Patient complaints against hospitals have skyrocketed, rising 79% in just 5 years and topping 14,500 in fiscal year 2024, HealthLeaders September 12 reports. The surge reflects not only mounting dissatisfaction with care experiences but also systemic oversight delays that leave concerns unaddressed, fueling mistrust in hospitals. The Centers…

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By: Tarsilla Moura
September 17, 2025
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CMS plan to phase out inpatient only list sparks debate over safety for vulnerable patients

Editor's Note The Centers for Medicare & Medicaid Services (CMS) is moving to eliminate its Inpatient Only (IPO) List over the next 3 years, a decision that could permanently shift more surgical procedures from hospitals to outpatient settings. According to an August 24 article from Fierce Healthcare, the policy promises…

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By: Tarsilla Moura
September 2, 2025
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CMS’s plan to phase out inpatient-only list could bolster rural ASCs

Editor's Note The proposal from the Centers for Medicare & Medicaid Services (CMS) to eliminate the Medicare Inpatient Only (IPO) list over 3 years could significantly expand opportunities for ambulatory surgery centers (ASCs), with rural facilities among those positioned to benefit most, Ambulatory Surgery Center News August 12 reports. The…

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By: Tarsilla Moura
August 26, 2025
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2026 ICD-10 updates bring hundreds of new codes, new complexity

Editor's Note Healthcare providers, payers, and analytics teams face sweeping ICD-10 changes this fall, with the 2026 code updates taking effect October 1, 2025, Wolters Kluwer July 14 reports. The release includes 614 new codes, 12 invalidations, 642 billability changes, 88 terminology revisions, and the creation of an entirely new…

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By: Tarsilla Moura
August 21, 2025
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Largest US healthcare fraud case reveals billions in false Medicare, Medicaid claims and vast schemes nationwide

Editor's Note The US Department of Justice (DOJ) has conducted the largest healthcare fraud takedown in US history, charging 324 individuals, including 96 licensed medical professionals, in schemes totaling more than $14.6 billion, HealthCare Business News July 8 reports. The nationwide crackdown involved 50 federal districts and 12 state attorneys…

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By: Tarsilla Moura
August 19, 2025
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