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Healthcare Fraud: A World Beyond the Anti-Kickback Statute

Americans spend more than $3 trillion per-year on healthcare-related expenses. Of that, the National Health Care Anti-Fraud Association estimates that between $60-250 billion is lost to fraud every year. Not all of those losses, however, relate to taxpayer-funded health insurance programs—such as state and federal Medicaid/Medicare—but involve losses to private payers and other non-traditional funding […]

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Intravascular Microaxial Left Ventricular Assist Device Manufacturer Payments to Cardiologists and Use of Devices

Mechanical circulatory support devices are increasingly used by physicians for patients receiving percutaneous coronary intervention (PCI). Use of intra-aortic balloon pumps (IABPs) has decreased, whereas use of intravascular microaxial left ventricular assist devices (LVADs) grew from 4.1% to 9.8% of all PCIs for acute myocardial infarction complicated by cardiogenic shock from 2015 to 2017, despite […]

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Adapting FMV Physician Compensation to CMS MPFS Changes

On November 2, 2023 the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule (“MPFS”) Final Rule which included a 3.37 percent decrease in the MPFS conversion factor from $33.8872 to $32.7442. The Final Rule also indicated the expiration of the 1.0 GPCI floor on December 31, 2023. However, on […]

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Provider Strategy reports on market developments and insights related to the healthcare provider workforce. Our publication is committed to improving the healthcare professional workforce, utilization of providers, and ultimately supporting thought leadership in workforce innovation.

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