Growing Medicare Expense ... Eyelid Lifts?

Critics say doctors, patients gaming the system

By John Johnson,  Newser Staff

Posted May 28, 2013 6:28 PM CDT | Updated Jun 1, 2013 1:45 PM CDT

(Newser) – Medicare is never, ever supposed to pay for cosmetic surgery, but the Miami Herald has dug up numbers on eyelid lifts that look mighty suspicious. Medicare will pay for the procedure—booming in popularity among aging Americans looking for less droopy eyes—but only if a doctor deems it medically necessary to restore peripheral vision. Here's where those suspicious figures factor in: The number of eyelid lifts covered by Medicare tripled to 136,000 a year from 2001 to 2011, and the amount doctors billed to Medicare quadrupled to $80 million.

The fishiness is summed up by former Medicare administrator Thomas Scully: “How many seniors among your friends or family have needed eyelid surgery?" he asks. "I bet a hell of a lot of them at 65 say, ‘You know what, I bet I can get Medicare to pay for this.’ And I can imagine the plastic surgeons love it. If you can go to patients and say that Medicare will pay, they will do it in much larger numbers.” The procedure is quick and lucrative, and fraud is tough to catch if a doctor decides to fudge the records a bit. Click for the full story.

  (Shutterstock)
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