OVERNIGHT HEALTH: Medicare cash flowed to docs charged with fraud

Doctors who have been charged with Medicare fraud over the last 16 months were paid $17 million of taxpayer money in 2012, according to an analysis by The Hill.

A majority of the Medicare reimbursements went to Detroit-area Dr. Farid Fata, who took home more than $10 million from Medicare in 2012.

Fata is accused of submitting false claims and conducting chemotherapy and other cancer treatments on patients who did not need them. He is currently in jail and has pleaded not guilty to charges against him, according to reports.

Seventeen of the 28 doctors The Hill looked at practiced in Michigan, and took home almost $13.3 million in 2012. The Justice Department has conducted a number of Medicare fraud stings in Michigan in recent years, charging 24 doctors in the state since January 2013.

The Hill analyzed data made available Wednesday by the Centers for Medicare and Medicaid Services in a landmark release that for the first time showed exactly how much is being paid to specific physicians in the program.

Jonathan Easley and Elise Viebeck at The Hill report.

Small slice, huge portion: A fraction of the country's doctors receive a disproportionate share of the $77 billion in Medicare payments made to physicians in 2012, according to data released Wednesday that provides a glimpse into the way healthcare dollars are spent. Just 100 doctors were paid $610 million in 2012, according to a report in The New York Times. A separate Wall Street Journal analysis of the data found that 1 percent of doctors accounted for 14 percent of the $77 billion in billings.

Many of the top earners were ophthalmologists and highly specialized oncologists.

According to a USA Today study, nearly $21 million went to a single ophthalmologist in Florida. Clinical laboratory workers and radiation therapy workers have by far the highest average pay under the program, each pulling in more than $1 million annually, according to the analysis. Read more at HealthWatch. 


Washington's leading post-acute-care lobby shop has promoted Elise Smith, formerly a senior vice president, to senior fellow for health policy and post-acute care. The American Health Care Association (AHCA) circulated news of Smith's move on Wednesday. She previously served in the Reagan administration as deputy undersecretary for the Department of Health and Human Services. In her new role, Smith will focus on site-neutral payment models. The AHCA did not announce a replacement.

Robert Zirkelbach, the spokesman for America’s Health Insurance Plans, will join PhRMA in May, he announced in an email to colleagues. Zirkelbach jumps from the nation’s largest health plans trade group to the nation’s largest pharmaceutical research and biopharmaceutical trade group. AHIP Deputy Press Secretary Clare Krusing will replace him in the interim. 


State by State:

LePage vetoes Medicaid expansion

Lawmakers search for cuts in Jindal budget

Kan. sees expansion of elderly care program

Insurers prodded to cover early addiction services for Vermonters

Reading List:

Want to see how problematic Medicare pricing is? Look at ophthalmology

Portrait of newly insured takes shape

Heart docs seek curbs on kidney-zapping hypertension devices

What you may have missed at HealthWatch:

GMO bill reignites labeling fight

Early enrollees in ObamaCare's insurance exchanges were sicker than the average patient