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Substance

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Check this out, on the WSJ of all places:

http://projects.wsj.com/medicarebilling/?standalone=1

Looks like pathologists are doing quite well at the top rungs; I think only ophthalmologists surpass them.

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Is this the total billed by different pathologists for 2012? I guess as expected the people diagnosing mostly gi, prostate, and derm were billing more and reimbursed more due to sheer volume.
 
Sorry, but this ain't income data. But, I guess that's how joe public (and Substance) sees it.
 
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Sorry, but this ain't income data. But, I guess that's how joe public (and Substance) sees it.

Exactly.

Any pathologist working in an in-office mill will show billings through the ceiling, but a huge chunk of that ultimately goes straight to the clinician owners, who appear modestly compensated by comparison. Pathologists appear falsely overcompensated and ripe for more fee cuts. Yet another reason to end these arrangements.
 
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Holy cow. The top two in my state (for payments) actually work for a massive urologist owned lab not far from me. Here is what is says for just one of them. The other had similar data.


Tissue exam by pathologist 4734 $78.43 $371,287.62
Cytp urine 3-5 probes cmptr 655 $301.69 $197,606.95
Cytopath cell enhance tech 2364 $73.36 $173,423.04
Immunohistochemistry 1398 $79.36 $110,945.28
Xm archive tissue molec anal 63 $33.33 $2,099.79
 
Holy cow. The top two in my state (for payments) actually work for a massive urologist owned lab not far from me. Here is what is says for just one of them. The other had similar data.


Tissue exam by pathologist 4734 $78.43 $371,287.62
Cytp urine 3-5 probes cmptr 655 $301.69 $197,606.95
Cytopath cell enhance tech 2364 $73.36 $173,423.04
Immunohistochemistry 1398 $79.36 $110,945.28
Xm archive tissue molec anal 63 $33.33 $2,099.79

I am seeing an identical trend in pathologists around here who work in urologist-owned labs. Everyone else billing medicare 100k or less, with those in the urologist and GI owned labs billing 600k and more.
 
There is a HUGE dropoff from the in-office pathologists to the rest of us here in my state. Looks like number 3 also works at another large urology lab north of me. That urology lab actually does Know Error DNA testing on their positive cases as well.
 
Doesn't appear BU Path has done any work? Has it all been farmed out? Must need more residents for income.
 
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Did anyone look at Los Angeles? Number 1 is 1.6 million and then number 2 is 245,000. Take that LADoc
 
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One thing is for sure looking at the data, In-office labs are making a killing off pathology.
 
This is Medicare payments, not billings. Does anyone out in practice have a rough idea what %age of a general pathologist's workload is on Medicare patients?

Also the top people in LA are all dermatopathologists (surprise). I looked at the #1 guy-- he is a dermatology-trained dermpath with a robust clinical practice. Feel free to check out his fine business: the LA Skin & Beauty Center.

Anyway he billed Medicare for 13,672 tissue examinations in 2012 in addition to his office workload (lots of procedures and patient visits), which given ~260 working days a year, is reading 53 cases a day. Is that realistic?

#2&3 are UCLA professors, also dermpath.
 
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Why is it that out of the top 20 pathologists, 13 are in Florida?
 
This is Medicare payments, not billings. Does anyone out in practice have a rough idea what %age of a general pathologist's workload is on Medicare patients?

Also the top people in LA are all dermatopathologists (surprise). I looked at the #1 guy-- he is a dermatology-trained dermpath with a robust clinical practice. Feel free to check out his fine business: the LA Skin & Beauty Center.

Anyway he billed Medicare for 13,672 tissue examinations in 2012 in addition to his office workload (lots of procedures and patient visits), which given ~260 working days a year, is reading 53 cases a day. Is that realistic?

#2&3 are UCLA professors, also dermpath.

I'd say 25-40 percent of your practice is typically Medicare for a hospital based pathologist depending on the community demographics you live in.

Nytimes reports that the third highest reimbursement of over 12000000 went to a pathologist in New Jersey. He must have made at least 30000000 in 2012 assuming he had a mix of Medicare and non-Medicare patients. Who the hell is this guy? It is guys like him that force cms to ratchet back reimbursement on all of us.
 
I'd say 25-40 percent of your practice is typically Medicare for a hospital based pathologist depending on the community demographics you live in.

That is about right. Although if you are well located within a large metro area, you can get down less than 25%.

Also, it is important to remember that these numbers don't say as much as people are making them out to say. For example, every pathologist around here bills medicare less than 100k per year (except the in office lab pathologists). All that means is we don't see many medicare patients. There are of course nuances that we have pointed out in this thread that probably no one will ever bring to the light of day (i.e. in office labs billing medicare for enormous amounts) and if they do, the CMS reaction will hurt all of us rather than selecting the offender.

Takes a lot of money to distract yourself from the fact that you're in Florida.

Well, no doubt. But this winter I would have given anything for blue ocean, green vegetation, 75 degrees, and sunny. I almost would have tolerated the rednecks you have to deal with in the majority of that state.
 
I'd say 25-40 percent of your practice is typically Medicare for a hospital based pathologist depending on the community demographics you live in.

Nytimes reports that the third highest reimbursement of over 12000000 went to a pathologist in New Jersey. He must have made at least 30000000 in 2012 assuming he had a mix of Medicare and non-Medicare patients. Who the hell is this guy? It is guys like him that force cms to ratchet back reimbursement on all of us.

That data for that pathologist in New Jersey is misleading. His provider code is used for all the doctors at the old Plus Diagnostics. There used to be like 27 there. They sold out to Miraca a while back if I remember correctly.
 
That website is more evidence of the war on physicians. It plays into the narrative that we are overpaid. Thank you Governement for putting this out there with little explanation. This data is quite misleading for some of us.

The only thing I get out of that website is in-office labs are making a killing. It's no coincidence that the highest pay outs for each state are in-office labs. They are clearly going to be in the government's crosshairs. Cracks me up when do a search and some indian/african pathologist that you have never heard of pops up pulling in nearly a million dollars.
 
That website is more evidence of the war on physicians. It plays into the narrative that we are overpaid. Thank you Governement for putting this out there with little explanation. This data is quite misleading for some of us.

The only thing I get out of that website is in-office labs are making a killing. It's no coincidence that the highest pay outs for each state are in-office labs. They are clearly going to be in the government's crosshairs. Cracks me up when do a search and some indian/african pathologist that you have never heard of pops up pulling in nearly a million dollars.

It is one more tool for the government to stir up class envy and create a totalitarian state where it sucks for everyone except for the politicians/bureaucrats.
 
It is one more tool for the government to stir up class envy and create a totalitarian state where it sucks for everyone except for the politicians/bureaucrats.

Expect many more of these dumb misleading Oh My God, Look at How Much Doctors Make! media exposes. I told you guys years ago that provider cuts are the only way Obamacare can function, the bureaucrats having bought off seniors, lawyers, Pharma and insurance companies in order to pass that monstrosity.
 
Holy cow. The top two in my state (for payments) actually work for a massive urologist owned lab not far from me. Here is what is says for just one of them. The other had similar data.


Tissue exam by pathologist 4734 $78.43 $371,287.62
Cytp urine 3-5 probes cmptr 655 $301.69 $197,606.95
Cytopath cell enhance tech 2364 $73.36 $173,423.04
Immunohistochemistry 1398 $79.36 $110,945.28
Xm archive tissue molec anal 63 $33.33 $2,099.79

Rather astounding that there are 4734 codes for tissue exam and 1400 for ipox. That's quite a high percentage if these are all prostate biopsies. If the second line is urovysion and the third line is urine cytology, that is also a pretty high percentage of cases to be reflexing to FISH. Could be wrong about what it means though.

There are some weird features of this data that do not make sense to me. I looked up the place where I trained and a lot of the pathologists listed there haven't worked in that city for several years - the highest biller is actually a former resident who graduated more than 5 years ago and practices like 50 miles away. And another one was a fellow from 2009 or 2010 who then took a job out of state.

In addition, these data are obviously misleading and lack certain qualifiers - like overhead expenditures. But they do tell a story. Lots of the emphasis is on ophthalmologists who say that most of the billing relates to drug prices which go right back to the drug company. But left unsaid is how much of that money then goes right back from the drug company to the doc.

But yes the highest biller in path in my state (by far, nearly double the next) is one who runs a large in office lab, although their's is pretty ethical from what I can gather so I shudder to think how high that could be if they borrowed other business practices. Their IPOX % was like 5%.
 
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There are some weird features of this data that do not make sense to me.

One of the most prominent pathologists in my area, who is nationally known and does loads of outpt work, is listed as being given <10K by Medicare in 2012. This is simply impossible - either the data are wrong, or he is billing in some other way that I am unfamiliar with. Also, the dermatopathologists at UCSF, whose whose famously high salaries are publicly listed by the state, are not found in the Medicare database. Actually, none of the UCSF dermpaths are there. Hmm...
 
One of the most prominent pathologists in my area, who is nationally known and does loads of outpt work, is listed as being given <10K by Medicare in 2012. This is simply impossible - either the data are wrong, or he is billing in some other way that I am unfamiliar with. Also, the dermatopathologists at UCSF, whose whose famously high salaries are publicly listed by the state, are not found in the Medicare database. Actually, none of the UCSF dermpaths are there. Hmm...

I know. Lots of missing data, maybe being billed in someone else's name? The biggest in office lab in our state is totally missing also. It also inflates many totals because they include others' work. Big flaw.
 
Rather astounding that there are 4734 codes for tissue exam and 1400 for ipox. That's quite a high percentage if these are all prostate biopsies. If the second line is urovysion and the third line is urine cytology, that is also a pretty high percentage of cases to be reflexing to FISH. Could be wrong about what it means though.

There are some weird features of this data that do not make sense to me. I looked up the place where I trained and a lot of the pathologists listed there haven't worked in that city for several years - the highest biller is actually a former resident who graduated more than 5 years ago and practices like 50 miles away. And another one was a fellow from 2009 or 2010 who then took a job out of state.

In addition, these data are obviously misleading and lack certain qualifiers - like overhead expenditures. But they do tell a story. Lots of the emphasis is on ophthalmologists who say that most of the billing relates to drug prices which go right back to the drug company. But left unsaid is how much of that money then goes right back from the drug company to the doc.

But yes the highest biller in path in my state (by far, nearly double the next) is one who runs a large in office lab, although their's is pretty ethical from what I can gather so I shudder to think how high that could be if they borrowed other business practices. Their IPOX % was like 5%.

Both of the pathologists at that operation have data that is very similar. Both have billed Medicare for over 850,000 in 2012.

I also looked up Strand Diagnostics, the makers of Know Error DNA testing. They billed Medicare for over 4.5 million dollars in 2012....... Our tax dollars going toward making sure the biopsy wasn't mislabeled or some other pre-analytic error. Pathetic..

There is a lot of interesting data on that website for sure.
 
This disclosure of Medicare payment to doctors is a HUGE, MASTERFUL move by those pushing for a lower reimbursement to doctors. They will push for further disclosure.

In reading POL income for 2012, for comparison to hospital based pathologists, you must subtract 1/3 of that income as TC expenses.

[/QUOTE]
 
Non sequitor. I definitely know at least one institution that is so breaking the law that they don't care about their own law breakers. Wt...?:help:
 
Both of the pathologists at that operation have data that is very similar. Both have billed Medicare for over 850,000 in 2012.

I also looked up Strand Diagnostics, the makers of Know Error DNA testing. They billed Medicare for over 4.5 million dollars in 2012....... Our tax dollars going toward making sure the biopsy wasn't mislabeled or some other pre-analytic error. Pathetic..

There is a lot of interesting data on that website for sure.

The concept of know error makes sense I guess but my questions are always these:
1) What are the chances a prostate biopsy is identified to the wrong man in this day and age?
2) What are the chances that the Know Error testing will be identified to the wrong man?
3) Is #2 SIGNIFICANTLY lower than #1?
 
This disclosure of Medicare payment to doctors is a HUGE, MASTERFUL move by those pushing for a lower reimbursement to doctors. They will push for further disclosure.

http://blogs.plos.org/onscienceblogs/2014/04/11/eyes-medicare-data-dump-cautions-cautionary-tales/

There is a lot of caution, which I guess is a good thing. Because the journalists quickly noticed that many of the highest "earners" were just conduits for lots of others' testing. Like the family doctor discussed above or the chair of the mayo lab. I think the focus is quickly turning to drug payments. Not as much focus on excessive procedures or hospital costs, media starting to realize just how big of an expenditure the drugs are.
 
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I just looked up my nemeses and apparently, not highly reimbursed by Medicare. These louses are relying on other people's Medicare billing to keep their jobs as common thugs aka leadership positions or only dx non-Medicare and private insurance. Anyway, the reimbursement does not reflect private insurance payments so I am sure this data is not the complete picture of payments. At least now, doctors who previously had no idea how much income they were generating for their groups have a sense of what is going down. It's important for the public to not confuse Medicare billings by pathologists as being their salary or what they actually make because of overhead and other expenses, although when you are talking 12million to one dr, justifying that requires some creative imagination. On the other hand we can see why selling and buying labs are big business because it's so lucrative. Why people get sued for leaving the group after it's sold or whatever, reason for non-compete clauses and other bs. There are also the useless molecular tests mentioned above, cms should ask the lab to pay to give back the payment if they can't keep their cases to the right patients. Seriously, how difficult is it to ensure that the patient's samples are properly processed! I didn't even know it was a common problem.
 
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I looked up a friend of mine who does pure dermpath for a local university. Her Medicare billing was 350k. Given that probably about 1/3 of her cases are Medicare and given that private insurance pays more than Medicare, she is likely generating over 1,000,000. Her reimbursement from the university is public information and available on the web. She makes made 250k in 2012. Nice 750k cut by the university. But she is junior. It will likely get better.

This information can be empowering.
 
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I looked up a friend of mine who does pure dermpath for a local university. Her Medicare billing was 350k. Given that probably about 1/3 of her cases are Medicare and given that private insurance pays more than Medicare, she is likely generating over 1,000,000. Her reimbursement from the university is public information and available on the web. She makes made 250k in 2012. Nice 750k cut by the university. But she is junior. It will likely get better.

This information can be empowering.

lmao, i wonder if this was the real reason behind Dr. KS leaving CMS cause all the admin who literally were scalping CMS are all pissed off now that even WSJ and those on the right also have had enough. Apparently, AMA issued several statements about the salary data. I think that when it is about issues such as this, they do not really qualify any particular opinion. Transparency and equitable treatment of others are key to long term success, rather than hoarding all the wealth at the top 0.1% and so on, everyone has had it with dorky leadership of health care and sacred stuff like that, i.e. academia etc.

ohh just saw this on another forum http://www.washingtonpost.com/blogs...hy-they-charged-121m-in-one-year/?tid=up_next
 
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The concept of know error makes sense I guess but my questions are always these:
1) What are the chances a prostate biopsy is identified to the wrong man in this day and age?
2) What are the chances that the Know Error testing will be identified to the wrong man?
3) Is #2 SIGNIFICANTLY lower than #1?

EVERY lab in this day and age should be able to prevent specimen mix ups without resorting to a 450 dollar DNA test. Strand diagnostics has at least one costumer that started doing DNA testing on FREAKING PAP TESTS last year. I shutter to think how much money is being spent on that. It's not a good use of our money. When you do search in my state of the entities that received the most Medicare money in 2012, Strand diagnostics was darn near the top of the list. I wasn't expecting that.

I love that website. When the tide rolls out, you can see who is swimming naked.
 
I looked up a friend of mine who does pure dermpath for a local university. Her Medicare billing was 350k. Given that probably about 1/3 of her cases are Medicare and given that private insurance pays more than Medicare, she is likely generating over 1,000,000. Her reimbursement from the university is public information and available on the web. She makes made 250k in 2012. Nice 750k cut by the university. But she is junior. It will likely get better.

This information can be empowering.

Well this is just as big of a misinterpretation of reality as Joe Public looking at Medicare database and coming away with the opinion that all docs are greedy millionaires. That "cut" has to pay for overhead, future investments, bad debts, etc. It's all a matter of risk / reward. Who bears the risk? Employee or employer? You want more of a cut? Own the business and take the incremental risk.
 
I
Well this is just as big of a misinterpretation of reality as Joe Public looking at Medicare database and coming away with the opinion that all docs are greedy millionaires. That "cut" has to pay for overhead, future investments, bad debts, etc. It's all a matter of risk / reward. Who bears the risk? Employee or employer? You want more of a cut? Own the business and take the incremental risk.
I do own the practice or at least a share so I know all about billing, contracts, reimbursement, overhead. State Universities don't really have risks. If they fail, taxpayers bail them out.
 
I

I do own the practice or at least a share so I know all about billing, contracts, reimbursement, overhead. State Universities don't really have risks. If they fail, taxpayers bail them out.

Does your practice have employee pathologists? Do they collect a large portion of their billings as compensation? If they do and your practice is able to invest in capital items the way it needs to to compete, your group is far more kind than the vast majority of participants in a capitalist society. Bravo.

In the real world, the rewards follow the risk 99% of the time. Universities have less of a chance of going under than private enterprise, but I don't think that gives them incentive to throw money to the employees. The department managers are still tasked with running the department as if it were a private business challenged with maintaining their operating margins and managing the assets the employees use to do the work.
 
Would anyone know when 2013 Medicare payment data will be released?
 
It seems that several pathology groups don't bill by individual pathologists but by the corporation instead. Try a search for your state using "clinical laboratory" instead of "pathology" as the specialty/facility type. The results are interesting. I didn't know that there were multiple ways to bill AP services - either as individual pathologist or as the corporation.

Looking nationally searching by 'clinical laboratory", Millennium Laboratories was raking it in. Genoptix and Miraca/Cohen dermpath seem to be doing very well. But, the data can be picky. For example, there are 2 ways to search Bostwick - "Bostwick Labs LLC" and "Bostwick Labs LLC."labs. There are at least 12 search entries for Quest, 15 for Ameripath, and 6 for LabCorp. In answer to my prior question, UCSF dermpath is listed as a clinical laboratory and not by individual pathologists.
 
All you have to do is claim you are offering "personalized medicine" and watch the dough roll in.

You get the impression from many companies that the personalized medicine era is here but in reality it has barely, barely begun.
 
guys don't be naive..if you really think this is transparency and will be empowering the patient that can't be farther from the truth..the government and majority of the media refused to provide context or even explain the numbers and instead painted the picture that this is take home salary for physicians to build up public outrage against physician salaries..it is extremely misleading and is only being used to set the stage for drastic cuts to reimbursements...see below for explanation

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.”
 
guys don't be naive..if you really think this is transparency and will be empowering the patient that can't be farther from the truth..the government and majority of the media refused to provide context or even explain the numbers and instead painted the picture that this is take home salary for physicians to build up public outrage against physician salaries..it is extremely misleading and is only being used to set the stage for drastic cuts to reimbursements...see below for explanation

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.”

In spite of protestation, the data show glaring instances of abuse. We should not defend the indefensible just because we are doctors.
 
Only the idiots and lazy allowed themselves to be identified in this mob round up. LADoc and others like him will continue to operate through multiple NPI# in multiple cities and stay under the radar.

It's all about the Bourne Identity...you will never find me on a list, especially a government one.

Plus Turtle you are a fool. The data doesnt uncover crap. All it does is initiate a witch hunt against doctors. This "data release" is a purposeful political ploy and it will backfire badly for the Dems who plotted and schemed to do this.

PS- Any pathologist who allowed their NPI to be used to bill for $10million+ in CP lab charges is a total tool. I dont even understand how this happens other than a very lazy lab billing apparatus...well time to wake up folks and be careful how, where and when your information is used in billing.
 
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Only the idiots and lazy allowed themselves to be identified in this mob round up. LADoc and others like him will continue to operate through multiple NPI# in multiple cities and stay under the radar.

It's all about the Bourne Identity...you will never find me on a list, especially a government one.

Plus Turtle you are a fool. The data doesnt uncover crap. All it does it initiate a witch hunt against doctors. This "data release" is a purposeful political ploy and it will backfire badly for the Dems who plotted and schemed to do this.

Yep. There's basically nothing that can be accurately inferred from this data other than "doctors get paid with Medicare". The folks that have things to hide or just simply don't want any scrutiny at all will figure out ways to spread the dollars across names and entities. It's not shocking this data would ever be released so you have to assume these people were prepared.

The only thing these lists are good for are for getting overreactions from the dumb and uninformed.
 
It is enlightening to hear the defense of, "I was just using my ID to bill for 25 other people", seriously, that's bollocks. I thought you couldn't technically swap medicare id numbers with whomever to bill whatever for whoever happens to work with you. The work billed for was supposed to be reflective of the physicians actual work, not by proxy of other professionals who cannot get credentialed thru medicare, which apparently is the easiest to get an id for and then, reimbursed for the work. Anyway, whatever.
 
Yep. There's basically nothing that can be accurately inferred from this data other than "doctors get paid with Medicare". The folks that have things to hide or just simply don't want any scrutiny at all will figure out ways to spread the dollars across names and entities. It's not shocking this data would ever be released so you have to assume these people were prepared.

The only thing these lists are good for are for getting overreactions from the dumb and uninformed.

If this is the first of many, as I believe, the data will improve.
 
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