Odd Treatments Bring a Few Doctors Medicare Millions

Surgeon billed for $3.7M—without doing surgery, WSJ finds
By Matt Cantor,  Newser Staff
Posted Jun 10, 2014 11:25 AM CDT
Odd Treatments Bring a Few Doctors Medicare Millions
The Wall Street Journal finds some doctors billing quite a bit for non-standard procedures.   (Shutterstock)

A rare heart treatment involving strapping patients to a bed using large cuffs that promote blood flow is rarely used by America's cardiologists; the Cleveland Clinic's 141 cardiologists used it on just six patients last year. But one LA internist used it on nearly all his 615 Medicare patients in 2012—bringing his practice $2.3 million from Medicare. Dr. Ronald Weaver is rarely even at his clinic, sources tell the Wall Street Journal; instead, they say it's run largely by someone who isn't a doctor. Employees are told to tell patients: "We are the experts at getting Medicare to pay when others wouldn't be able to."

In 2012, some 2,300 health care providers received at least $500,000 for just one procedure, the Journal reports. Though that's not "inherently wrong," Weaver is just one of several doctors profiled by the paper who have used similarly uncommon procedures and sent the government giant bills. A Massachusetts doctor performed an unusual urological procedure 1,757 times in 2012; other urologists who billed Medicare for the same treatment used it an average of 38 times. A dermatologist in Florida scored $2.41 million for a treatment only two other doctors billed for. And an orthopedic surgeon got $3.7 million without doing any surgery; instead, he chiefly billed Medicare for "manual therapy techniques"—essentially, massage. His cryptic response to questions on the billing: "What you see, it wasn't me." (The New York Times recently looked at how one physical therapist billed Medicare for $4 million.)

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