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UnitedHealthcare requiring stricter notification requirements for out-of-network ASC referral

UnitedHealthcare (UHC) recently issued a notification to approximately 80 California physicians reminding them that their participation agreement requires them to refer to in-network ambulatory surgical centers (ASC) for elective services. This notice comes on the heels of an August 2016 announcement that UHC will begin enforcing stricter notification requirements related to out-of-network ASC referrals. According to the UHC letter, physicians wishing to perform services at an out-of-network ASC will be required to notify UHC at least five days in advance of the procedure. Additionally, physicians will be expected to ...

IMQ Granted Deeming Authority for ASCs by CMS

On April 29, 2016, the Institute for Medical Quality (IMQ) was officially recognized as a national accrediting organization for ambulatory surgical centers (ASCs) that participate in the Medicare or Medicaid programs. This approval by the Centers for Medicare and Medicaid Services (CMS) came following a comprehensive review process to ensure that IMQ’s Standards of Accreditation meet or exceed Medicare’s Conditions for Coverage.“Our physician surveyors are highly experienced in systems that promote optimal patient care. We are pleased that CMS recognizes our expertise and profound commitment to patient safety and ...