WASHINGTON (CBS SF/AP) – Following decades of secrecy, Medicare officials have released information showing exactly how much the program pays individual doctors, with some getting more than $20 million in 2012. California had 38 of the doctors on the list getting over $3 million, some getting far more than that.
The release of such payment records has been legally blocked since 1979. At that time, federal officials had planned on releasing the information, but the American Medical Association and Florida Medical Association sought an injunction to stop the process. They argued making the information public would violate physicians’ privacy and a judge ruled in favor of the groups. The ban was lifted in May of 2013, in response to a Freedom of Information Act request by Dow Jones & Co.
Health and Human Services Secretary Kathleen Sebelius announced the release of new, privacy-protected data on services and procedures provided to Medicare beneficiaries by physicians and other health care professionals.
“Currently, consumers have limited information about how physicians and other health care professionals practice medicine,” said Secretary Sebelius “This data will help fill that gap by offering insight into the Medicare portion of a physician’s practice. The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns.”
The data also includes payment and submitted charges, or bills, for those services and procedures by a provider.
The American Medical Association, which has long opposed release of the Medicare database, is warning it will do more harm than good.
The AMA says the files may contain inaccurate information. And even if the payment amounts are correct, the AMA says they do not provide meaningful insights into the quality of care. “We believe that the broad data dump … has significant shortcomings regarding the accuracy and value of the medical services rendered by physicians,” AMA president Ardis Dee Hoven said. “Releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions and other unintended consequences.”
An Associated Press analysis found that a small sliver of the more than 825,000 individual physicians in Medicare’s claims data base – just 344 physicians – took in top dollar, at least $3 million apiece for a total of nearly $1.5 billion.
About 1 in 4 of the top-paid doctors – 87 of them – practice in Florida, a state known both for high Medicare spending and widespread fraud. 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.
In the $3 million-plus club, 151 ophthalmologists – eye specialists – accounted for nearly $658 million in Medicare payments, leading other disciplines. Cancer doctors rounded out the top four specialty groups, accounting for a combined total of more than $477 million in payments.
This Washington Post article has a handy tool that will allow you to type in the name of a physician and find out the statistics provided by Medicare officials.
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