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Medicare payment to some doctors in the millions

In the name of transparency and accountability, the U.S. government released data for more than 880,000 distinct healthcare providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service.
By Alex Cukan   |   April 9, 2014 at 6:24 PM   |   Comments

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WASHINGTON, April 9 (UPI) -- In the name of transparency and accountability, the U.S. government released data for more than 880,000 distinct healthcare providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service.

Part B claims include doctor visits, laboratory tests, out-patient treatment under Medicare -- not treatment received in a hospital or nursing home, not private commercial insurance, Medicaid or Medicare Advantage plans. The disclosure involves 6,000 different types of services and procedures provided for payments received by individual doctors or practices.

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“Currently, consumers have limited information about how physicians and other health care professionals practice medicine,” Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said in a statement.

“This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice. The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns: "http://www.hhs.gov/news/press/2014pres/04/20140409a.html" target="_blank" title="HHS"

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Almost $100 million was paid to physicians and healthcare providers in 2012.

HHS said consumers can view the physician dataset at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html.
Most the of the data involves relatively modest amounts being paid to physicians, but 2 percent accounted for 23 percent of Medicare fees.

The average annual Medicare payout for an ophthalmologist in 2012 was $430,000, but a Florida ophthalmologist headed the list by charging $26 million to treat fewer than 900 patients and a Florida cardiologist received $23 million in Medicare payments -- about 80 times the average amount for that specialty, the Los Angeles Times reported. The top recipient of Medicare money, Florida ophthalmologist Salomon Melgen, who billed Medicare $26 million, was already under federal investigation before the data was made public.

However, both government officials and physicians's groups warned the data could be misleading because some doctors might specialize in geriatric care and almost all of their payments might be from Medicare or some physicans might be cardiologists who mostly see patients age 65 and older in their own medical facility that includes that payments for doctors, but also staff, medical devices, tests, medications used in treatment and supplies.

Medicare, which covers about 60 million elderly and disabled patients, is forecast to cost more than $600 billion this year.

[HHS]

[Los Angeles Times]

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