In Medicare's data trove, clues to curing cost crisis
Somewhere in the New York City area there is a family-practice doctor who, government records suggest, pocketed more than $2 million in 2008 from Medicare, the federal insurance program for the elderly.
That made her one of the best-paid family-medicine physicians in the Medicare system. But more noteworthy than the sum is her pattern of billing, which strongly suggests abuse or even outright fraud, according to experts who have examined her records.
This doctor didn't do typical family medicine. Instead, she administered a wide array of sophisticated tests, including polysomnography sleep analyses, nerve conduction probes and needle electromyography procedures—some of which have been flagged by federal antifraud authorities for special scrutiny. As a doctor of osteopathy, she has certifications for family practice and a hands-on treatment called "manipulative therapy," but none in neurology. She denies wrongdoing.
- EHR Systems 'Immature, Costly,' AMA Says
- Better HCAHPS Scores Protect Revenue
- Narrow Networks Cut Costs, Not Quality, Economists Say
- CEO Exchange: Preparing for Population Health
- Interstate Medical Licensure Effort Advances
- 'Early Offer' Malpractice Programs May Spur Reform
- Anthem Blue Cross, 7 CA Health Systems Create New Challenger, Business Model
- 3 Strategies for Retaining Millennial Employees
- Advocate, NorthShore Deal Would Create 16-Hospital System
- How to Build a Health Plan from Scratch