Specialty Care Providers

Providers, Lawmakers Say #StopTheCuts to Physician Fee Schedule

by Jacqueline LaPointe

With payment reductions looming for many providers paid under the Medicare Physician Fee Schedule, hundreds of medical organizations and lawmakers are pushing Congress to stop rate cuts finalized in...

Provider Groups Update Guidance on Maintaining Surgery Amid COVID-19

by Jacqueline LaPointe

Four of the healthcare industry’s leading associations have revamped guidance on maintaining essential surgery as the number of COVID-19 hospitalizations surges across the country again. The...

CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

by Jacqueline LaPointe

New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final...

Lawmakers Seek Bipartisan Solution for Physician Fee Schedule Cuts

by Jacqueline LaPointe

Over 200 Representatives are calling on Congress to examine possible bipartisan solutions to address proposed Medicare Physician Schedule cuts for certain specialties, including surgical care. In a...

CMS Finalizes Alternative Payment Models for Specialty Care

by Jacqueline LaPointe

CMS is transitioning more specialty care to value-based reimbursement with two new alternative payment models for end-stage renal disease and cancer care. A final rule released late last week unveiled...

Out-of-Network Bills Common for Some Pathologists, Other Specialists

by Jacqueline LaPointe

Out-of-network billing occurs infrequently for most specialty providers, but a select few always or nearly always bill out of network for inpatient and outpatient services, according to a new report...

42% of Anesthesiologists Had Contracts Terminated in Last 6 Months

by Jacqueline LaPointe

Anesthesiologists are being forced out of network as private insurers terminate their physician contracts with little to no notice, according to a recent survey conducted by the American Society of...

Out-of-Network Primary Care Linked to Higher ACO Costs

by Emily Sokol, MPH

Patients receiving primary care outside of their defined accountable care organization (ACO) network drive up costs for ACOs, a recent study from Portland State University said. The Medicare Shared...

Out-of-Network Billing for Hospital Care Boosts Spending by $40B

by Jacqueline LaPointe

Patients receiving care at in-network hospitals face a significant risk of out-of-network billing for services performed by hospital-based anesthesiologists, pathologists, radiologists, and assistant...

Recent Articles