KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Analysis Of Medicare Pay Shows Variations In Drugs Used And Earnings By Specialists

The Washington Post examines how drugs administered by doctors is different in various regions of the country. Other outlets look at other issues, including how eye doctors are among the highest paid specialty.

The Washington Post: Cost Of Drugs Used By Medicare Doctors Can Vary Greatly By Region, Analysis Finds
An analysis of government data released Wednesday shows that the cost of drugs administered by doctors accounts for a growing piece of Medicare’s spending and varies widely from region to region in the United States, raising questions about whether some physicians may be misusing the pharmaceuticals. Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments, those records show (Whoriskey, Keating and Sun, 4/9).

Los Angeles Times: Medicare Pay Data Shock And Anger Many Doctors Listed As High Earners
Like dozens of other doctors across the country, [Newport Beach oncologist Minh] Nguyen was unwittingly thrust into the spotlight as federal officials listed for the first time what the government pays individual doctors to treat elderly Americans. Some of those with the highest billings had already drawn public scrutiny as part of government investigations into healthcare fraud. But many more doctors were shocked to see where they ranked, since Medicare hadn't shared the data with physicians before publication (Terhune and Smith, 4/9).

The Washington Post: Doctors React To Release Of Medicare Billing Records
Doctors reacted swiftly and indignantly to Wednesday’s release of government records revealing unprecedented details about Medicare payments to physicians. Many resented being included on a list that showed some doctors billing Medicare for millions of dollars. The top 10 doctors alone received a combined $121.4 million for Medicare Part B payments in 2012 (Millman and Fallis, 4/9).

The New York Times: Eye Doctors Say Their Profits Are Smaller Than Data Makes Them Look
Although consumers and health experts will be poring over the newly released Medicare data for months, maybe years to come, one startling piece of information has already emerged, demonstrating some of the complexity inherent in the long-fought-over information on 880,000 health care providers across the country. More than any other specialists, ophthalmologists — not cardiologists, cancer doctors or orthopedic surgeons — were the biggest recipients of Medicare money in 2012 (Pollack and Abelson, 4/9).

The Wall Street Journal: Medicare Payment Data Throw Spotlight On Potential Abuses
Some doctors who received large sums from Medicare in 2012 have had run-ins with the law, signaling how the government's unprecedented move to make such payments public could throw up red flags for potential abuse. The physician paid the most by Medicare in 2012 is a high-profile south Florida ophthalmologist who has been fighting with the federal government for years over allegations of overbilling (Mathews, Carreyrou and Barry, 4/9).

The Wall Street Journal: Medicare Paid One Doctor More Than $20 Million In 2012
The doctor who was paid the most by Medicare in 2012 is a high-profile south Florida ophthalmologist who has been fighting with the federal government for years over allegations of overbilling. Salomon Melgen, whose practice was searched twice last year by the Federal Bureau of Investigation, got $20,827,340.74 from the Medicare program in 2012. With four offices and 30 employees, Dr. Melgen draws almost 70% of his patients from the program, according to court documents, and often performs injections of medications to treat macular degeneration, a condition that can cause blindness (Mathews and Schwartz, 4/9).

The New York Times: Political Ties Of Top Billers For Medicare
Two Florida doctors who received the nation's highest Medicare reimbursements in 2012 are both major contributors to Democratic Party causes, and they have turned to the political system in recent years to defend themselves against suspicions that they may have submitted fraudulent or excessive charges to the federal government (Robles and Lipton, 4/9).

The Washington Post’s Wonkblog: Want To See How Problematic Medicare Pricing Is? Look To Ophthamology
One particularly striking example in the new data: billing in ophthalmology. The data show that there were nearly 4,000 individual physicians who each billed Medicare for at least $1 million in 2012 alone. As The New York Times noted, ophthalmology was the specialty that billed the highest total (Ehrenfreund, 4/9).

The Associated Press: Top-Paid Medicare Doctors Say They Have Reasons
How is it that a few doctors take in millions of dollars from Medicare? Explanations for Wednesday’s eye-popping numbers from Medicare’s massive claims database ranged from straightforward to what the government considers suspicious, as the medical world confronted a new era of scrutiny (Alonso-Zaldivar and Tumgoren, 4/9).

Politico Pro: No Top Medicare Billers Among Docs In Congress
The doctors in Congress don't appear to be breaking Medicare’s bank, but the government's massive payment disclosure Wednesday shows that some of their family members have brought in sizable sums. Of the 24 House and Senate members who are physicians, just four collected Medicare reimbursements in 2012, according to the CMS database of 2012 billings. The two members who were in Congress at the time received relatively small sums. Rep. Bill Cassidy (R-La.) drew $588 as an associate professor at Louisiana State University who occasionally provides care as a gastroenterologist. Rep. Scott DesJarlais (R-Tenn.) brought in $2,422, but his office explained Wednesday that the payment was for a nurse practitioner running his general medical practice since he no longer sees patients (Cunningham, 4/9).

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