Asante Health System and one of its physicians, have agreed to pay $430,000 to settle allegations that the company and its physician knowingly submitted false claims for payment. The United States contends that, between January 1, 2015, and January 31, 2021, Asante and Dr. Charles Carmeci, a cardiothoracic surgeon practicing at Asante Rogue Regional Medical Center, knowingly submitted claims for payment to Medicare, Medicaid, and TRICARE for cardiothoracic surgeries including decortications, PleurX catheter placements, pericardiectomies, mediastinal mass resections, patent foramen ovale, atrial septal defect closures, and Bentall procedures, knowing they did not meet the criteria for reimbursement or were otherwise improper.
Baptist, the state’s largest healthcare provider, says it and other hospital groups have faced “unprecedented” costs since the pandemic, but has seen stingy reimbursement deals from insurers. The insurers, in turn, say that they can no longer pass along ever-higher health costs to employers and policyholders.
MedPAC members voted to recommend a 1.3% increase to the scheduled Medicare rates for doctors and other providers. Advisers also recommended that clinicians get extra payments for services provided to low-income Medicare patients in 2025.
The cumbersome prior authorization process has become a first-class challenge for patients and my fellow physicians. According to a survey by the American Medical Association, 94% of physicians reported delays in care due to the prior authorization process, with 33% saying the prior authorization process has been the root cause of serious adverse effects on patients.
A report from the AMGA 2023 Medical Group Operations and Finance Survey shows that the operational costs for medical groups are outpacing revenue gains. With data gathered from over 15,000 providers, the survey sheds light on the complex challenges faced by medical groups in delivering quality and cost-effective care.
Claxton-Hepburn Medical Center announced Carthage Area Hospital will take over managing five clinics. But the man engineering the changes says they keep hundreds of healthcare jobs in Ogdensburg, and honor employees’ pensions. To split the current Claxton Hepburn Medical Center in Ogdensburg into two separate facilities, New York state has to say ok. The split would create an expanded, stand-alone behavioral health inpatient facility, owned by Claxton.