Also known as IOM, intraoperative neuromonitoring is almost always relatively inexpensive when compared to the overall cost of a surgery itself, but far too often IOM companies willing to stretch the bounds of normal billing practices find themselves the beneficiaries of six-figure insurance payments.
IOM, common during many types of back surgeries, provides a surgeon with a technological “heads-up” should he or she start coming too close to potentially doing any long-term damage to the patient’s central nervous system.
During a year-long investigation, 9NEWS uncovered multiple instances in which insurance companies paid bills that were hundreds of times the typical payment for IOM. In each case, the company chosen by a surgeon to perform the IOM just so happened to be the same company that had, in past years, paid that surgeon -- a partner in the company -- handsomely.
“It’s a shame for the medical system and for the integrity of physicians as a whole,” said one Colorado doctor. “It’s unethical, and it’s immoral.”
Among other things, the 9Wants to Know investigation has found:
- A relatively small number of Colorado insurance claims for IOM cost insurance carriers, on average, $63,076 per case, between 2012 and 2016 (the median Medicare payment during the same time was $100)
- A trio of IOM procedures led to a $400,000 payout to one IOM company -- a company with close ties to the surgeon who utilized the service
- That Colorado surgeon pocketed nearly a half-million dollars in one year from his partnership with an IOM company
- IOM companies who try not to let surgeons in on their profits suggest they’re losing business as a result
Insurance companies don’t like talking about it; neither do the very hospitals that allow the practices to continue.
And until three patients decided to share their stories with 9Wants to Know, the story had drawn little attention in the public sphere.
As the husband of one of those patients told us, “It’s pretty obvious something is going on behind the scenes.”