Friday, April 11, 2014

Medicare Pay Disclosure Reveals Seven $10 Million Doctors (BusinessWeek)



Seven doctors each earned more than $10 million in Medicare-related payments in 2012, according to claims data released by the U.S. government Wednesday. Nearly 4,000 earned $1 million or more.
Doctors’ groups have long opposed making public this kind of data about their Medicare pay on grounds that it might be unfair to doctors and taken out of context by the public. The Obama administration decided to release it in an effort to identify potential fraud and waste in the program. The spreadsheet released by the government contains more than 880,000 rows of data, one for each doctor, lab, or other medical provider receiving payments from Medicare.
In all, the data cover about 825,000 doctors. Of that pool, roughly one in five took in more than $100,000 in Medicare payments. The totals don’t count doctors’ income from other sources, including private insurance.
Ranked by specialty, internists collected the most in aggregate—Medicare paid more than $8.7 billion to these primary care doctors. They were followed by ophthalmologists, cardiologists, ambulance providers, and clinical labs.
As my colleague Peter Waldman explained on Tuesday, courts first sealed Medicare payments in 1979, and the American Medical Association has subsequently succeeded in shielding the data. “A lot of people on Medicare will drop their coffee cups when they see how much their doctors are making,” Jean Mitchell, a Georgetown University economist, told Waldman. While some practitioners have legitimate reasons for high billings, there’s undoubtedly some abuse in the sprawling program. The FBI estimates that from 3 percent to 10 percent of health-care dollars are fraudulently spent.
The top recipient of Medicare payments in 2012 was a West Palm Beach ophthalmologist identified by the government as Salomon Melgen. He collected $20.8 million, according to the data. Melgen could not be reached for comment late on  Tuesday.
Melgen, a big donor to Senator Robert Menendez (D-N.J.), last year was raidedtwice by the FBI. A statement from his lawyer published by WPTV in October noted that Melgen was cooperating with investigators and referred to a legal effort “to stop the government from trying to suspend his Medicare payments.”

John_tozzi
Tozzi is a reporter for Bloomberg Businessweek in New York.

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