Doctors making millions off of medicare!!!

[Cellpathology]

http://money.cnn.com/2014/04/09/news/economy/medicare-doctors/index.html?hpt=hp_t2

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[InGen]

 

[HopefulReapp]

Why do doctors have to be so greedy, ugh

 

[e30ftw]

Grocery clerks make millions off food stamps!

 

[Raryn]

In other news, the car salesmen at my local Mercedes dealership each made $5,000,000 last year. (100 cars x $50,000 each=$5,000,000 in income, right?)

 

[Cellpathology]

Michelle obama also spends 10 million dollars per trip!!!

 

[JJMrK]

The comments on that page are actually not as bad as I thought they would be. I suspect that the average reader understands the difference between gross and net income, or has at least been reminded of it recently by 4/15.

 

[evilbooyaa]

The comments on that page are actually not as bad as I thought they would be. I suspect that the average reader understands the difference between gross and net income, or has at least been reminded of it recently by 4/15.

Agreed. I was expecting to see a lot more of "OMg doctors make so much money I can't believe" in the comments.

 

[Cellpathology]

Actually I would say about 50% of the comments are unreasonable, which is too many, though honestly I did expect more

 

[Shikima]

OMG! I make too much money! I need to give it back.... (said no one evar!)

 

[Cellpathology]

OMG! I make too much money! I need to give it back.... (said no one evar!)

LOL don't you remember the news article a few years back where "two dozen millionaires" stormed the nation's capital and got in front of the cameras that were conveniently already in position and demanded that washington raise their taxes?! HAHA what a crock : http://money.cnn.com/2011/11/16/news/economy/tax_millionaires/

 

[Top Gun]

I was making millions all this time off of Medicare patients??? Really, who'd have thought??? Then how come my savings and checkings accounts are so much smaller?

 

[Rendar5]

I looked myself up and found that I'd made $27,000 off of Medicare, thank you Medicare. in other news I think I spent that a lot of my taxes on Medicaid anyway, and the rest was taken out on overhead. That was a half year of work. I need to figure out how to reach the $100,000 mark before reaching the $1000000 mark though.

 

[Paddington]

I come from a medical family. When I was younger I used to think that anyone financially very successful in medicine was a very good, hardworking doctor.

Now that I've been doing medicine for several years myself, the reality is a little different. No matter what field you're in, you can only reasonably bill so much. On top of that, everyone should be working hard to keep down healthcare costs to keep it affordable for everyone, but in reality very few private practice doctors give a damn about costs to the third party insurers with regards to procedures (that the doctors benefit from) or expensive medications (that someone else benefits from), beyond anything other than wanting to avoid getting complaints from patients regarding their copays. Anyone making huge amounts of money relative to their colleagues is *usually* doing something shady.

This story came out and in a local newspaper they analyzed top local billers and found that some of these same doctors have fraud cases pending against them. Why does that not surprise me?

The public deserves to have access to this kind of information. And maybe the government should look at some total cap that any one person can bill. I believe this is how the Canadian single payer, yet fee for service system works. I think it would cut down on considerable abuse in the system, as well as making the opportunities to see patients more equitable amongst providers.

 

[brilliantlyconfusedMD]

I have a suggestion, let's put the salaries of CEOs for insurance plans, health systems, pharmaceutical companies, health policy makers side by side these numbers for comparison.
I'm not saying those who bill Medicare millions are honest or not, it's just the way this information is relayed to the public that is harmful to the already somewhat damaged reputation of us doctors.

 

[DermViser]

Why do doctors have to be so greedy, ugh

You obviously don't really understand how Medicare billing works.

 

[HopefulReapp]

You obviously don't really understand how Medicare billing works.

It was sarcasm :-(


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[JJMrK]

The public deserves to have access to this kind of information. And maybe the government should look at some total cap that any one person can bill.I believe this is how the Canadian single payer, yet fee for service system works. I think it would cut down on considerable abuse in the system, as well as making the opportunities to see patients more equitable amongst providers.

The solution would then be to stop seeing Medicare patients once you hit the cap. Considering that the practitioners likely to hit this cap are probably among those actually willing to see a large volume of Medicare patients, this seems like the worst possible idea I can think of.

 

[KGflyboy]

The solution would then be to stop seeing Medicare patients once you hit the cap. Considering that the practitioners likely to hit this cap are probably among those actually willing to see a large volume of Medicare patients, this seems like the worst possible idea I can think of.

I agree. That would be crazy.

I envisioned signs on docs doors that said, "Closed til January because we reached our yearly cap.". Or even better, " we reached our yearly cap, so all costs for chemo, retina injections, surgeries, etc are due up front. Cash only."

 

[Winged Scapula]

I looked myself up and found that I'd made $27,000 off of Medicare, thank you Medicare. in other news I think I spent that a lot of my taxes on Medicaid anyway, and the rest was taken out on overhead. That was a half year of work. I need to figure out how to reach the $100,000 mark before reaching the $1000000 mark though.

That was interesting. I made $68,615 off Medicare in 2012 but my patient population is largely private insurance.

 

[Winged Scapula]

The solution would then be to stop seeing Medicare patients once you hit the cap. Considering that the practitioners likely to hit this cap are probably among those actually willing to see a large volume of Medicare patients, this seems like the worst possible idea I can think of.

Some of that already occurs. It is very common in private practice to limit the number of patients with "x" insurance to a few slots a day.

 

[oncology2020]

for those that didn't see the link, here is some more context from the actual physicians that were called out by the media just based on the raw numbers provided by the government...the government refused to provide context or explain the numbers to the average person. It's so extremely misleading--and done so purposefully. There is a systematic campaign against doctors salaries--this only benefits the government, insurance industries, hospital administrations, medical device industry and pharma who are making billions already and are the real reasons for high healthcare costs--they dont want the spotlight on them. Please be pro-active and educate the average person about the truth, comment on articles if you have to, in order to protect your field. Don't fall for the BS about transparency and fighting fraud.

http://www.washingtonpost.com/blogs...hy-they-charged-121m-in-one-year/?tid=up_next

Michael McGinnis, a pathologist who received the third-highest payout from Medicare in 2012, said the numbers provided by CMS don’t tell the whole story. He is the medical director for PLUS Diagnostics, a New Jersey-based company. He said because the company uses his medical ID number to do all the billing, the $12.6 million in Medicare funds billed in his name actually represents the work of 26 pathologists, each of whom can complete hundreds of tests in a day. Biopsies account for much of that work, he said.

“The money doesn’t come to me,” McGinnis said. “It goes to the company. It goes to PLUS Diagnostics.”

Franklin Cockerill, a doctor for the Mayo Clinic in Rochester, Minn., is No. 4 on the list with $11.1 million in reimbursements. As the government-recognized director for Mayo Clinic Laboratories, Cockerill is routinely listed as the billing physician on more than 23 million tests a year, a Mayo spokesman explained.

"When anything is billed out to Medicare, it will have Dr. Cockerill’s name on it,” said Andy Tofilon, marketing administrator with Mayo Medical Laboratories. “He is the chair of a large laboratory medicine practice and the buck stops at his desk.”

Cockerill has been at the Mayo Clinic for more than 30 years and held his current position for more than five years, Tofilon said. Cockerill is salaried and has “no financial stake by being included in all of these reports,” Tofilon said.

The laboratory performs testing for Mayo Clinic patients and clients nationwide, and Cockerill does not personally review or approve each test, according to Tofilon. “No human could look at this much paperwork,” he said.

Tofilon said the number of tests billed through Mayo Clinic Laboratories is especially large because the vast majority of the clinic’s testing is done in Rochester. Other labs, he noted, often have locations scattered across the country.

“His name is submitted on all the claims,” Tofilon said. “Anytime someone puts in a request to Medicare and we did the test at Mayo Clinic, they will include his information on the claim.”

Vasso Gadioli, a vascular surgeon from Bay City, Mich., is No. 6 on the list with $10.1 million. He said he gets paid about $3,000 per procedure for inserting stents in his office, but he said he is still saving Medicare money. If he did the procedure in a hospital, he gets $500 and the hospital receives $8,000, Gadioli said.

About 70 percent of Medicare payments to Gadioli went to overhead. Then he has to factor in other costs, like employee salaries and taxes.

“Roughly a surgeon will take home 10 cents a dollar," said Gadioli, who has been in practice 12 years. "If I earned for myself one-tenth of [$10 million], that’s pretty good."

Jean Malouin, a family practitioner in Ann Arbor, Mich., and the highest-ranking woman on the list, suggested her perch at No. 17 is misleading. "I am most definitely not a high volume Medicare biller!" she wrote in a email.

Malouin said that she has a small private practice but is also the medical director of an experimental University of Michigan project trying to improve care and cost-efficiency at nearly 400 clinics across the state. All the project's claims are paid in her name, which probably explains why the data show she treated more that 200,000 patients and collected about $7.6 million from Medicare.

Minh Nguyen, a hematologist-oncologist at Orange Coast Oncology in Newport Beach, Calif., was listed as the 10th-highest biller of Medicare in 2012. He said all the billings for chemotherapy drugs at his five-physician practice were under his name.

“It looks like I’m getting paid $9 million ... but it’s a pass through,” he said. “The majority of the billing goes to pay the drug companies."

John C. Welch, an ophthalmologist in Hastings, Neb., ranks eighth on the list of top billers. Like most ophthalmologists on the list, a majority of his billings come from the shots he gives patient with macular degeneration — and that money is passed onto the drug companies, he said.

He said he bills so often because he is only one of a few local doctors who can perform the procedure. That generally keeps him working a 12- or 13-hour day.

“I service a large rural area,” he said. “I’ve been trying to recruit another doctor out here for years.”

He also notes: “I don’t control what Medicare decides to pay the drug company.”

 

[oncology2020]

Some of that already occurs. It is very common in private practice to limit the number of patients with "x" insurance to a few slots a day.

unfortunately at some point the government will pass legislation legally requiring doctors to see medicare/medicaid patients

 

[Poliscidoc]

unfortunately at some point the government will pass legislation legally requiring doctors to see medicare/medicaid patients

Not going to happen... We'll let's hope not

 

[NotAProgDirector]

All of the above sounds totally reasonable, except for poor Vasso.

Vasso Gadioli

, a vascular surgeon from Bay City, Mich., is No. 6 on the list with $10.1 million. He said he gets paid about $3,000 per procedure for inserting stents in his office, but he said he is still saving Medicare money. If he did the procedure in a hospital, he gets $500 and the hospital receives $8,000, Gadioli said.

About 70 percent of Medicare payments to Gadioli went to overhead. Then he has to factor in other costs, like employee salaries and taxes.

“Roughly a surgeon will take home 10 cents a dollar," said Gadioli, who has been in practice 12 years. "If I earned for myself one-tenth of [$10 million], that’s pretty good."

Now wait a second....

$10.1 million income.
$3000 per stent.
That's 3300 stents in a year [Yes, I am ignoring any medicare billing for office visits, but they are chump change]
Let's say he actually works 5 days a week for 46 weeks = 230 work days.
That's 3300/230 = 14 stents a day. Not including any office visits.

I especially like the suggestion at the end that he's only taking home $1 million a year.

 

[Substance]

The public deserves to have access to this kind of information. And maybe the government should look at some total cap that any one person can bill. I believe this is how the Canadian single payer, yet fee for service system works. I think it would cut down on considerable abuse in the system, as well as making the opportunities to see patients more equitable amongst providers.

This is not how it works in Canada, at least not in my province. They tried something like that years ago. What happened was that a doc would work to the cap, and then take the next four or five months off. Nobody wants to work for free.

 

[colbgw02]

All of the above sounds totally reasonable, except for poor Vasso.


Now wait a second....

$10.1 million income.
$3000 per stent.
That's 3300 stents in a year [Yes, I am ignoring any medicare billing for office visits, but they are chump change]
Let's say he actually works 5 days a week for 46 weeks = 230 work days.
That's 3300/230 = 14 stents a day. Not including any office visits.

I especially like the suggestion at the end that he's only taking home $1 million a year.

If that truly is per stent (and not per patient), then that 14 stents/day number could really only be about 3-5 cases a day, especially if he happens to have an affinity for short segment stents. Not too difficult to see that happening in a busy, efficient practice.

 

[SouthernSurgeon]

If that truly is per stent (and not per patient), then that 14 stents/day number could really only be about 3-5 cases a day, especially if he happens to have an affinity for short segment stents. Not too difficult to see that happening in a busy, efficient practice.

Yeah I was going to say I think the issue is that this indicates that he is just going full metal jacket on peoples' arteries.

 

[Arcan57]

Not going to happen... We'll let's hope not

Control of the healthcare system is being centralized because it's too difficult and expensive to try and regulate at the individual physician level. While not happening at a federal level anytime soon, I could definitely see accepting Medicare/Medicaid patients as a condition of licensure at the state level. The ideal scenario for the government is that we are all employees of ACOs and the government only has to negotiate with a handful of gigantic ACOs. This would allow the government to indirectly negotiate drug prices by squeezing the ACOs which then squeeze the drug companies by threat of switching to a competitior's me-too drug or risk losing significant sales when their drug becomes unapproved. But I'm rambling off topic.