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Doctors’ deals with surgical monitoring firms under scrutiny

Business arrangements between neuromonitoring companies and surgeons are raising concerns because of the impact those deals have on healthcare bills, according to a report from the Austin American-Statesman.

At least one insurance company, Aetna, also is looking into the medical necessity of some of the monitoring that surgeons have ordered. Neuromonitoring is the practice of inserting needle electrodes into patients to monitor their nervous system during delicate procedures.

With the Affordable Care Act’s new focus on paying doctors for quality care rather than quantity of procedures performed, the article says some doctors might be on the lookout for new ways to keep revenue up, even if it means skirting the law or making patients pay more out of pocket.

According to the Statesman, the business arrangements often involve surgeons using a neuromonitoring company’s services in return for a share of the bill. They will sometimes use the service even if it’s medically unnecessary. That practice “may constitute a kickback,” said Dr. George Lee, president of the American Society of Neurophysiological Monitoring.

“Physicians feel the pressure, and they feel entitled to make more money after all of the years of school and sacrifice,” Peter Chatfield, a partner at Phillips & Cohen LLP, told the Austin newspaper. “There are a lot of kickback schemes.”

“The people playing by the rules get shut out…and it’s costing the taxpayers a huge amount.”

Because neuromonitoring is often out of network, the bill can be sky-high for the unsuspecting patient.

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