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Health Care Reform:

Health Insurance & Affordable Care Act

By Mark Crane

Medscape Medical News

Some Doctors Paid Millions by Medicare

April 10, 2014 -- The Centers for Medicare & Medicaid Services (CMS) today released, for the first time, data detailing about $77 billion in payments to more than 880,000 health care professionals under its Medicare Part B Fee-For-Service program.

"We've taken a huge step today in making the Medicare program more transparent to the public and researchers," Jonathan Blum, CMS principal deputy administrator, said in a telephone news conference. "For too long this information was not available. Medicare is funded with taxpayer dollars, and the public has a right to know this information. This data release can help reduce fraud and waste in the system.

"We want the public, press, and researchers to mine the data to help us find outliers, and identify spending that doesn't make sense or appears to be wasteful or fraudulent," he says.

Almost 4,000 doctors were paid more than $1 million each in 2012 by Medicare, and the average payment per doctor was $77,000 for that year, according to multiple media reports.

Medicare paid 344 doctors $3 million or more, and one Florida eye doctor was paid $21 million in 2012, according to an analysis of the database. Cancer doctors specializing in blood work and radiation each averaged more than $360,000 in annual payments.

In the $3 million-plus group, 151 eye doctors accounted for nearly $658 million in Medicare payments, according to an analysis by the Associated Press.

Eye and cancer doctors received the highest payments because both professions use very expensive drug treatments as part of their practice, Blum says.

Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez (D-NJ) made headlines last year after it was disclosed that Menendez used the doctor's personal jet for vacation trips, was paid $20.8 million.

About 1 in 4 of the top-paid doctors practice in Florida. Rounding out the top five states were California, with 38 doctors in the top group; New Jersey, with 27; Texas, with 23; and New York, with 18.

CMS is looking at releasing data from previous years and plans to release updated hospital data within 8 weeks, Blum says.

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