A glance inside the physician 'gravy train'
Two U.S. senators have introduced legislation to overturn a 1979 court injunction that bars the government from revealing what individual physicians earn from Medicare.
The Medicare Data Access for Transparency and Accountability Act, or DATA Act, was introduced by Sens. Ron Wyden (D-Ore.) and Charles Grassley (R-Iowa). They both serve on the Senate Finance Committee, which has jurisdiction over Medicare.
The information is stored in the Medicare-claims database, widely considered one of the best tools for finding fraud and abuse in the $500 billion federal health insurance program for the elderly and disabled.
Soaring Medicare costs threaten to overwhelm the federal budget, yet American taxpayers are blocked from seeing exactly where their money goes. Under a three-decade-old court order, Medicare cannot publish the billings of individual physicians who participate in the program.
The AMA has vigorously fought opening the records to the public on the grounds that doing so infringes on the privacy rights of doctors. I think of it as protecting the federal gravy train that many physicians have exploited to great financial advantage over the years.
The Wall Street Journal was able to gain limited access to these records and has identified abuse and fraud that led to the prosecution of physicians.
The Journal used the data to detect potentially negligent or harmful care. It identified an Oregon neurosurgeon who had an unusual propensity for performing multiple spine surgeries—as many as seven—on the same patients. The physician denied wrongdoing and said he acted in the best interest of his patients.
I would like to thank the Senators and the journalists at The Journal who pursued this on behalf of all of us who want to see abuse of the system identified and prosecuted to the fullest extent of the law.
We can all lend a hand in fighting Medicare abuse. If you suspect Medicare abuse contact the Medicare fraud and abuse hotline at, 1-800-HHS-TIPS (1-800-447-8477).
Jeff Kreisberg blogs regularly at takingcontrolofyourhealthcare.com.
