A small group of doctors accounted for a large chunk of Medicare payments once again, data released Monday by the U.S. government show.
Medicare paid at least 3,900 individual health-care providers at least $1 million in 2013, according to a Bloomberg analysis of data from the Centers for Medicare and Medicaid Services. Overall, the agency said it released data on $90 billion in payments to 950,000 individual providers and organizations. On average, doctors were reimbursed about $74,000, though five received more than $10 million.
The U.S. has been increasing transparency for Medicare, which accounts for the largest portion of federal spending after defense and Social Security. The centers also released information Monday about $62 billion in Medicare payments to hospitals and outpatient facilities in 2013, reflecting more than 7 million discharges.
Monday's data exclude the privately run program known as Medicare Advantage, which accounted for about 30 percent of beneficiaries last year, and the drug prescription benefits of Medicare Part D. Payments in the drug program were released for the first time earlier this year.
Some payments were sent to organizations rather than individuals. There are about 897,000 active physicians in the U.S., according to the Kaiser Family Foundation.
The two highest-paid doctors in 2013, both of Florida, are now under legal scrutiny. Cardiologist Asad Qamar, who was No. 1, has since been accused by the Justice Department of billing for unnecessary tests and cardiovascular procedures. He received about $15.9 million in payments in 2013.
"Procedures performed in Dr. Qamar's outpatient clinics cost Medicare on average about half of what the same procedure would cost in a hospital," said Greg Kehoe, Qamar's attorney, in an emailed statement. "Additionally, amputation rates in his patient population were the lowest in the U.S. -- 80 percent below average -- with each avoided amputation saving the government at least half a million dollars."
In a video released in January, Qamar called the government's claims baseless.
Salomon Melgen, the eye doctor charged along with U.S. Sen. Robert Menendez in a bribery case, was No. 2 and got $14.4 million. The U.S. has said he improperly diagnosed patients' eye diseases and gave them unnecessary treatments, and accused him of health care fraud.
"We intend to prove that in both instances the charges are ill-founded, that he is not guilty of these charges," said Matthew Menchel, an attorney for Melgen.
Medicare covers more than 55 million people, including the elderly. Payments for inpatient and outpatient care accounted for the bulk of Medicare's budget, while doctors got about 16 percent of spending, excluding Medicare Advantage.
The U.S. spent about $586 billion on Medicare in 2013, or about 20 percent of the country's health care spending.
Medicare payments to doctors were long kept from the public after medical associations argued in the early 1980s that their release would violate physicians' privacy. In May 2013, a federal judge lifted a 33-year-old injunction on the data after a lawsuit by Dow Jones & Co. President Barack Obama's administration decided in 2014 to make all payment information public.
Last year, some of the doctors who were shown as receiving the biggest payments said multiple members of their medical groups were billing using a single provider identifier. Doctor groups also faulted the data for including reimbursements for drugs to physicians, not just payments for procedures.
For instance, many eye doctors topped the 2012 data because they received payments to cover the cost of a treatment for degenerative eye disease that they administer in their offices. This year, the United States is including an explanation of that drug payment system and identifying payments tied to drugs. Medicare typically pays doctors 6 percent more than the average cost of medications administered in that manner.
While the data have improved from last year, they still don't reflect the quality of care patients received and still could be open to misinterpretation, the American Medical Association said in a statement Monday.
Information for this article was contributed by Rob Zuvich of Bloomberg News.
A Section on 06/02/2015