KSJ Tracker April 9, 2014

AMA loses 35-year-battle to keep Medicare payments secret--and the payments are stunning.

Medicare, the government-run health program for older Americans, paid one doctor $20.8 million in 2012.

Of the 825,000 doctors in Medicare's claims database, 344 took in at least $3 million each, for a total of $1.5 billion.

This data has been kept private since 1979--35 years ago--by a court injunction sought by the American Medical Association that barred release of any details of these expenditures of public money. The injunction was vacated by a federal judge last year.

This data from the Medicare claims database was released today by the federal government, which called this a "historic release of data."

The word I'd use is not historic, but outrageous. The first two facts above come from an Associated Press  story by Ricardo Alonso-Zaldivar and Serdar Tumgoren. The third comes from Christopher Weaver, Tom McGinty, and Louise Radnofsky, writing in The Wall Street Journal. (The Journal says three others contributed to the piece.)

The AP noted in its second graf that the doctor topping the list--Salomon Melgen, a Florida ophthalmologist who pulled down the $20.8 million--"made headlines last year" after news broke that Sen. Robert Mendez of New Jersey had used Melgen's personal jet for trips to the Dominican Republic.

The Journal didn't mention Menendez. Both stories reported that 344 doctors took in at least $3 million each, for a total of $1.5 billion. And 151 ophthalmologists in that exclusive club earned a total of $658 million in Medicare payments. Eye doctors were the top earners.

An annual take of $3 million or more per year breaks down to at least $60,000 a week, or $12,000 or more per day. How many pairs of glasses is that? Melgen made $84,000 a day.

You might wonder why the AMA fought for decades to keep this information secret. But you shouldn't. These figures are outrageous. (I know, I'm repeating myself.) The AMA was right to suspect that doctors wouldn't come out looking very good if we knew how much public money they were taking.

The New York Times, in a story by Reed Abelson and Sarah Cohen, led with some of the same astounding financial figures I've led with here.

It's early days--the information was released only hours ago--but I'm surprised that the role of the AMA in keeping the data secret hasn't yet been hit hard in these publications. It's stunning that it was able to keep this information secret for 35 years; I'm waiting for the legal story that examines how that happened. (I don't see anything up on ProPublica yet, but that would be a good place to look. You might also try Slate, The Atlantic, and The New Yorker later today.)

In the meantime, enjoy reading about the money some doctors are making, and, if you like, look up your own.

-Paul Raeburn


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