Federal data shows which doctors reap Medicare millions
Family physician Tatiana Pavlova Greenfield, who practices in Maryland, may have received an average of more than $86,000 per patient that year, according to the Reuters review, and $3.3 million in total. That compares to an average of $2,200 per Medicare patient in 2012. Asked for comment, an employee at the office where Greenfield worked said she "had left the country."
In addition to allowing patients to see which doctors perform a particular procedure most frequently often a proxy for expertise in rare and difficult surgeries such as colon operations — the data are expected to offer a road map to where waste and fraud are most rampant, not only in the Medicare program but throughout the American health care system.
Medicare paid physicians, physical therapists, nurse practitioners, chiropractors and other individual providers $77 billion in 2012. About two-thirds of Medicare's total $540 billion in payments that year went to hospitals and most of the rest to prescription drugs.
The data released on Wednesday include the names and addresses of physicians who submitted claims to Medicare in 2012, along with the codes for the approximately 6,000 services Medicare covers. It lists the number of times providers billed for each service, the average submitted charge and how much that deviated from the national norm.
Last December, the inspector general of the Department of Health and Human Services, CMS' parent agency, found that 303 clinicians each collected more than $3 million from Medicare Part B in 2009, triggering "improper payment reviews" for 104. Those reviews identified $34 million in overpayments. Three of the clinicians had their medical licenses suspended; two were indicted.
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