CMS Releases Medicare Data
Written by Editor   
Tuesday, April 08, 2014 12:00 AM

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.

The two highest-paid doctors listed in the Medicare data are already under government review because of suspected improper billing. They include an ophthalmologist in the retiree haven of West Palm Beach, Fla., who topped the list by taking in more than $26 million to treat fewer than 900 patients. That is 61 times the average Medicare payout of $430,000 for an ophthalmologist.

A Florida cardiologist received $23 million in Medicare payments in 2012, nearly 80 times the average amount for that specialty. One California doctor was in the top 10 nationwide: a Newport Beach oncologist who was paid $11 million that year.

The overwhelming majority of doctors billed the government very modest amounts. Overall, 2% of healthcare providers accounted for 23% of the Medicare fees, the federal data show.

The disclosure of physician payments follows the federal government's release last year of hospital charges that showed wild variations among medical centers for the same procedure.

The highest-paid physicians in Medicare primarily worked in three specialties: internal medicine, radiation oncology and ophthalmology.  This new data show similar patterns. Many ophthalmologists are among the high-volume physicians because common eye conditions — cataracts, glaucoma and age-related macular degeneration — are overwhelmingly found in elderly patients.  In addition to physicians, the new information sheds light on payments to laboratories, outpatient surgery centers, ambulance companies and imaging centers.