Tags: Medicare | doctors | healthcare | billing

Report: Taxpayers Pay Hefty Bill for Doctors' Unusual Procedures

Tuesday, 10 Jun 2014 09:19 AM

More than 2,300 doctors earned more than $500,000 each from Medicare in 2012 from a single medical procedure, The Wall Street Journal reported.

Some of these doctors were paid far more money from these unusual procedures than anyone else who billed for them, according to government information obtained by the newspaper through freedom of information access.

Although the report singles out several doctors, the Journal noted that the providers they featured said their treatment was based on the best healthcare for the patients and not the amount of money they were paid. And some doctors said they were saving Medicare money by keeping patients out of hospitals.

The Journal pointed out that Robert Weaver, who is an internist in Los Angeles and not a cardiologist, received $2.3 million from Medicare in 2012, 98 percent of which was for a cardiac procedure.

The treatment involved having a patient strapped to a bed with three large cuffs that inflate and deflate to increase blood flow through the arteries. It is used to treat patients with severe chest pains who cannot undergo surgery, the Journal reports.

The government data shows that just 239 doctors, out of the thousands of cardiologists paid by Medicare, used it on fewer than 5 percent of their patients. However, in Weaver’s case he performed the technique on 99.5 percent or 615 of his Medicare patients.

There is no agreement among cardiologist on whether the treatment provides significant benefits, says the Journal, which also pointed out that the 2,300 doctors who made most of their money from just unusual procedures were often operating outside their areas of expertise.

Another doctor who was named in the report is urologist Evangelos Geraniotis of Hyannis, Massachusetts, who received nearly $1 million from Medicare for a procedure called "cystoscopy and fulguration."

The treatment, which is not common in urology offices, involves threading a scope up the male urethra to cauterize pre-cancerous lesions inside the bladder.

There are 8,791 urology specialists in Medicare, and of those, 973 billed for the procedure, with an average of 38 times a year.

Dermatologist Gary Marder of Port St. Lucie, Florida, who specializes in treating melanoma with radiation, received $2.41 million from Medicare for the treatment.

However, the Journal noted that he was just one of three doctors who billed for the radiation procedure in 2012. The other two doctors did not come close to Marder’s billing for the unusual treatment.

James Beale, an orthopedic surgeon in Michigan, was paid $3.7 million by Medicare in 2012, which is more than any other doctor in his field despite never having performed one surgery, according to the Journal analysis.

The figure included $2.3 million for "manual therapy techniques," which Medicare describes as a massage of various regions of the body, lasting 15 minutes.

Beale’s practice billed Medicare 107,670 times for the procedure in 2012, compared to other doctors and physical therapists who performed the technique 520 times and were paid less than $11,000 each on average for the year.

The Journal report noted that a doctor’s Medicare bill for an unusual procedure often included the work of a staff, including other doctors, physician assistants, and nurses.

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More than 2,300 doctors earned more than $500,000 each from Medicare in 2012 from a single medical procedure, The Wall Street Journal reported.
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