Medicare Paid Doctor $21M in Single Year

He's one of 344 who received at least $3M in 2012

By Rob Quinn,  Newser Staff

Posted Apr 9, 2014 3:15 AM CDT

(Newser) – Medicare's books have been opened up after an extended legal battle, and perhaps the most startling detail is that a single doctor was reimbursed nearly $21 million in 2012 alone. Florida ophthalmologist Salomon Melgen was one of 344 physicians who raked in more than $3 million from Medicare that year, accounting for nearly $1.5 billion of the $64 billion paid to individual doctors in 2012, an AP analysis of the data finds. (Lab and ambulance services bump the total Medicare paid out to $77 billion.) The highest paid 2% of doctors accounted for nearly a quarter of total Medicare payments, and in the $3 million-plus club, the category leader was ophthalmologists; 151 of them accounted for nearly $658 million in Medicare payments.

The physician data released by the Obama administration had been off-limits to the public for decades and will be pored over in the weeks to come by researchers, fraud investigators, insurers, and consumers, reports the New York Times. Groups who pushed for the release of the database argue that it will speed up payment delivery reform and help guide patients to doctors who deliver quality care, but the American Medical Association, which opposed the release, warns that "releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions, and other unintended consequences." The Washington Post sounds a few notes of caution, pointing out that some high-billing doctors' totals could be explained by their efficiency or heavy number of Medicare patients; further, some specialized procedures incur significant overhead, meaning a chunk of the money could end up in the hands of drug or medical device companies.

Medicare gave Dr. Salomon Melgen 20.8 million reasons to smile in 2012.
Medicare gave Dr. Salomon Melgen 20.8 million reasons to smile in 2012.   (AP Photo/Miami Dade College, Phil Roche, File)
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