KHN Morning Briefing

Summaries of health policy coverage from major news organizations

WSJ: Medicare Records Show Trail Of Troubling Surgeries

The Wall Street Journal continues its examination of Medicare's claims databases to uncover potentially fraudulent activities. Meanwhile, The Miami Herald reports on one alleged fraud perpetrator who is now awaiting trail.

The Wall Street Journal: Medicare Records Reveal Troubling Trail Of Surgeries
A Medicare database analyzed by The Wall Street Journal reveals that Dr. Makker has had an unusual propensity for performing such multiple surgeries on the spine. The data show that in 2008 and 2009, Dr. Makker performed spinal fusions on 61 Medicare patients. In 16 of those cases, he performed a total of 24 additional fusions. That gave him an overall rate of 39 additional fusions per 100 initial fusions, the highest rate in the nation among surgeons who performed spinal fusions on 20 or more Medicare patients during those two years. For the past year, the Journal has been mining Medicare's claims databases to expose how some doctors potentially defraud the taxpayer-funded health program for the elderly and disabled and game its reimbursement system (Carreyrou and McGinty, 3/29).

The Miami Herald: FBI Nab Man Accused In Medicare Fraud Case
A few years ago, Ernesto Angel Montaner was overheard bragging at a wedding reception that the FBI would never be able to touch him -since he'd been the only defendant acquitted in a vast healthcare fraud case in the 1990s. He doesn't have much to boast about anymore. He's stuck behind bars at a federal detention center in downtown Miami awaiting trial on Medicare fraud charges (Weaver, 3/28). 

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.