By Kate Penz, Communications and Foundation Manager
Ann Little, MD, was surprised when she learned that her staff had been contacted by a representative from the U.S. Attorney General’s office. Her reaction was understandable, “Why do they want to talk to me?”
Physicians receiving such calls may feel anxious about becoming involved in investigations and concerned about demands on their time. However, it is important to return these calls to help us educate key health care professionals, particularly now that the Center for Medicare and Medicaid Services’ (CMS) cut reimbursement for electrodiagnostic (EDX) procedures.
“AANEM members have the opportunity to partner with government agencies to inform them of what’s considered fraud and what’s not,” said Catherine French, senior analyst of medical economic affairs.
While several factors contributed to CMS’ decision to reduce EDX reimbursement, combatting fraud and abuse is a CMS priority. Jonathan Blum, director at CMS, cited pressure to cut spending and concern over fraud and abuse as major reasons for the 40-70% cuts to EDX reimbursement during a meeting with AANEM representatives
in December 2012.
Education and awareness efforts surrounding fraud and abuse are important to restoring fair compensation for EDX services. Dr. Little took advantage of the opportunity and educated the U.S. Attorney General about AANEM’s efforts to combat fraud and abuse.
“It turns out that the representative was investigating specific shady practices of another physician, a non-neurologist treating neuropathy pain,” said Dr. Little. “I made a point to explain the appropriate practice of neuromuscular medicine, offered them information on board certification, and invited them to contact AANEM for further conversation. The representative was very receptive, even appreciative.”
“Dr. Little did everything right and the conversation was very productive,” said French. “Other members are encouraged to follow her lead.”