KHN Morning Briefing

Summaries of health policy coverage from major news organizations

CMS Releases Trove Of Medicare Physician Billing Data

The Centers for Medicare & Medicaid Services is making this information available for the first time in 35 years. Meanwhile, in their first run at the data, news outlets report that a small number of doctors account for a large share of Medicare costs.  

The New York Times: Sliver Of Medicare Doctors Get Big Share Of Payouts
A tiny fraction of the 880,000 doctors and other health care providers who take Medicare accounted for nearly a quarter of the roughly $77 billion paid out to them under the federal program, receiving millions of dollars each in some cases in a single year, according to the most detailed data ever released in Medicare's nearly 50-year history (Abelson and Cohen, 4/9).

The Washington Post: Data Uncover Nation's Top Medicare Billers
The Medicare program is the source of a small fortune for many U.S. doctors, according to a trove of government records that reveal unprecedented details about physician billing practices nationwide. The government insurance program for older people paid nearly 4,000 physicians in excess of $1 million each in 2012, according to the new data. Those figures do not include what the doctors billed private insurance firms (Whoriskey, Keating and Sun, 4/9).

The Wall Street Journal: Small Slice Of Doctors Account For Big Chunk Of Medicare Costs
The long-awaited data reveal for the first time how individual medical providers treat America's seniors—and, in some cases, may enrich themselves in the process. Still, there are gaps in the records released by the U.S. about physicians' practice patterns, and doctors' groups said the release of such data leaves innocent physicians open to unfair criticism (Weaver, McGinty and Radnofsky, 4/9).

Los Angeles Times: Release Of Medicare Doctor Payments Shows Some Huge Payouts
Ending decades of secrecy, Medicare is showing what the giant healthcare program for seniors pays individual doctors, and the figures reveal that more than a dozen physicians received in excess of $10 million each in 2012. The Obama administration is releasing a detailed account Wednesday of $77 billion in government payouts to more than 880,000 healthcare providers nationwide that year. The release of payment records involving doctors has been legally blocked since 1979, but recent court rulings removed those obstacles. No personal information on patients is disclosed (Terhune, Levey and Smith, 4/8).

USA Today: First Look At Medicare Data In 35 Years
Reimbursements to doctors who provide Medicare services in 2012 ranged from nearly $21 million to a single Florida ophthalmologist to the $27,000 for the average anesthesiologist, according to the first look at government payment data in 35 years. The data were released this week by the Center for Medicare Services after a court order lifted an injunction sought by the American Medical Association had been in place since 1979 (Hoyer and Kennedy, 4/9).

Politico: Medicare Pay Data Laid Bare
Yet the massive release brings what federal health officials tout as a measure of transparency to a notoriously inscrutable system. Academic researchers and the media are expected to immediately begin dissecting the information to identify potential cases of fraud or abuse as well as differences in how Medicare services are used in various parts of the country (Norman, 4/9).

The Associated Press: Medicare Database Reveals Top-Paid Doctors
Topping Medicare’s list was Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez, D-N.J., made headlines last year after news broke that the lawmaker used the doctor’s personal jet for trips to the Dominican Republic. Medicare paid Melgen $20.8 million. AP’s analysis found that a small sliver of the more than 825,000 individual physicians in Medicare’s claims data base — just 344 physicians — took in top dollar, at least $3 million apiece for a total of nearly $1.5 billion. ... About 1 in 4 of the top-paid doctors — 87 of them — practice in Florida, a state known both for high Medicare spending and widespread fraud (Alonso-Zaldivar and Tumgoren, 4/9).

The New York Times: Doctor With Big Medicare Billings Is No Stranger To Scrutiny
The doctor who bills the most for Medicare in the country is a South Florida ophthalmologist whose offices were twice raided last year by the FBI and whose generous political contributions and cozy relationship with New Jersey Senator Robert Menendez are under investigation by federal public corruption prosecutors, a New York Times analysis of Medicare data shows (Robles, 4/9).

Bloomberg: Top Medicare Doctor Paid $21 Million in 2012, Data Shows
A doctor who treats a degenerative eye disease in seniors was paid $21 million by Medicare in 2012, twice the amount received by the next ophthalmologist on a list of 880,000 medical providers released by the government. The data on the payments was given to the public for the first time today by the Centers for Medicare and Medicaid Services. The list, a detailed account of how $77 billion in federal health-care funds were spent in 2012, showed a wide range in which some top earners were paid as much as 100 times the average for their respective fields (Chen and Pearson, 4/9).

Here's the Centers for Medicare & Medicaid Services provider data site

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