Gov’t Pays $21 Million to Medicare Doctor: 6,400% more than Peers in Same Field

medicare data
Science & Medicine

medicare dataOn a list of over 880,000 medical providers released by the government recently in association with Medicare costs for 2012, a startling case was presented to the public, that unfortunately, is all too common with our government-botched health care system. One doctor who treats degenerative eye diseases in seniors made $21 million from medicare, more than 64 times that of his peers in the same field.

Medicare fraud is more prevalent than one might think; however, how can the government realistically pay this much to a single provider without some alarm bells going off? And if our government is so incredibly broke, why is taxpayer money being spent to line the pockets of a few individuals milking the system?

“When I was prosecuting Medicare fraud cases years ago, it was often difficult even for us as prosecutors to get Medicare data in a timely fashion,” said Jay Darden, a partner at Patton Boggs LLP in Washington who left the Department of Justice in 2010. “So the notion that now it’s not only being released, but released to the public, that could very well signal a recognition from CMS that it’s had a problem in the past and it needs to do something about it.”

Data on these types of payments was made transparent to the public for the first time this week by the Centers for Medicare and Medicaid Services. It details how our government spent over $77 billion in federal health-care funds on numerous providers, but many made more than 100 times the average in their fields.

Read: FDA – Drug Companies Faked Thousands of Drug Documents

“Deterring improper payments is a top priority of CMS in order to protect beneficiaries and taxpayers,” said Aaron Albright, a CMS spokesman. The agency “is working with our contractors to develop an appropriate cumulative payment threshold that considers costs, as well as potential benefits in determining which claims and providers should be selected for further scrutiny.”

Advocacy groups for transparent government spending and consumer protection have urged data to be released on the true costs of Medicare to taxpayers, with an interest in highlighting fraud. The ophthalmologist, Salomon Melgen, who made 6400 percent more than other doctors who treated eyes and who is part of a criminal probe involving U.S. Senator Robert Mendez, was paid $20,827,341.

He appealed a 2009 ruling that found he over-billed Medicare by more than $8.9 million, but he was not alone. Another physician, Farid Fata, a Michigan oncologist, was paid similarly. His earnings were $10,063,281, and he was also charged with Medicare fraud.

Who exactly is in charge of Medicare’s payment policies? Surely it is easy to spend taxpayers’ money, instead of your own, but 6400 times the average? That’s many a million wasted while hard working individuals can hardly count on a living wage in their fields.