OIG: Electrodiagnostic Testing is an Area Vulnerable to Medicare Fraud

HHS' Office of the Inspector General has released the results of a study that found electrodiagnostic testing is an area vulnerable to "fraud, waste and abuse."

For its study, the OIG developed seven measures of questionable billing then used the measures to analyze electrodiagnostic test claims submitted by physicians in 2011.

The study made the following findings.

  • More than 4,900 physicians had questionable billing for Medicare electrodiagnostic tests in 2011.
  • The questionable billing for 2011 totaled $139 million.
  • 20 percent of the physicians who had questionable billing in 2011 for electrodiagnostic tests had received comparative billing reports in 2011 based on their 2010 billing for electrodiagnostic tests.
  • New York City, Los Angeles and Houston had the highest total questionable billing for Medicare electrodiagnostic tests in 2011.

Based on the study's findings, the OIG recommended CMS "increase monitoring of billing for electrodiagnostic tests, provide additional guidance and education to physicians regarding electrodiagnostic tests and take appropriate action regarding physicians" who the OIG identified as having questionable billing.

More Articles on Medicare Fraud:

Disciplinary Actions Against Michigan Healthcare Professionals Reaches New High
Physicians Still Receive Medicare Payments Even After Being Banned From Government Programs 
5 Recent FCA Employee Whistle-Blower Case Settlements 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars