Data trove shows U.S. doctors reap millions from Medicare

Reuters ^ | April 9, 2014 12:24am EDT | SHARON BEGLEY AND M.B. PELL

[Uncle Chip]

These are probably specialists like orthopedic surgeons doing hip/knee replacements and ophthalmologists doing cataract surgery.

[Uncle Chip]

Here’s the moneyline:

Topping Medicare’s list was Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez, D-N.J., made headlines last year after news broke that the lawmaker used the doctor’s personal jet for trips to the Dominican Republic. Medicare paid Melgen $20.8 million.

http://news.yahoo.com/database-docs-getting-millions-medicare-071303908—politics.html

Dave 31 minutes ago 0 3

Im in a 20+ group of ophthalmologists, and I cant wrap my head around billing more than a million to medicare per doctor as a high max, and most of us bill about half that and that amount doesnt even cover overhead per doc, because of expensive high tech equipment and trained personnel needed to run it, dependent on other insurances. Eye surgeons get paid a standard fee per state for cataract surgery, typically about $650 to $700 per case, you can google the amount, and cataract surgery has a high overhead. The hospital/surgery center fee is much higher, but that goes to the hospital.

I read that $21 million or even the $3 million and not possible....this guy is clearly not practicing ophthalmology, he must own several hospitals or a very busy one or ambulatory surgery centers. Either that or he personally sees thousands of patients per day, ie not possible. I would be willing to bet each one of those billing that much is from owning surgery centers that many other surgeons operate at and most of that goes to overhead, otherwise, just not possible to bill anywhere near that amount practicing ophthalmology.

[Uncle Chip]

So. Fla. eye surgeon under scrutiny with Sen. Menendez frequently prescribed expensive drug

http://www.miamiherald.com/2013/02/07/3222772/so-fla-eye-surgeon-under-scrutiny.html

A South Florida eye surgeon who’s a friend of a U.S. senator is under federal criminal investigation for billing Medicare millions of dollars to treat elderly patients for services they may not have needed, The Miami Herald has learned.

Federal agents began investigating Dr. Salomon Melgen last year, sources say, after investigators suspected he overbilled the taxpayer-funded health program by overprescribing a high-priced drug called Lucentis, which is injected into patients’ eyes.

Several sources familiar with the doctor’s practice said he used the drug, which costs $2,000 a vial, to treat patients with macular degeneration more than any other ophthalmologist in Florida and possibly the country. His high patient volume also raised red flags for investigators, the sources said.

[SC DOC]