CMS releases Medicare physician payment information, includes some nursing home affiliations

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Long-term care providers and residents now can glean insights into where their local doctors stack up nationally by referring to newly released data on Medicare physician payments. For the first time ever, the government made this information publicly available Wednesday.

The release from the Centers for Medicare & Medicaid Services also lists some organizations that physicians are affiliated with, including nursing homes. For example, it shows a clinical psychologist associated with Rosewood Nursing and Rehabilitation Center in Peabody, MA, who received about $132,000 from Medicare in 2012.

Much of the initial attention focused on the roughly 4,000 doctors who received more than $1 million each from Medicare in 2012. These included doctors providing very expensive care, such as oncologists, as well as leaders at prominent research institutions including the Mayo Clinic.

Ophthalmologists also were among the highest paid — including the doctor at the top of the list, Salomon Melgen of West Palm Beach, FL. Most of Melgen's billings were for injections of Lucentis, an expensive eye drug used to treat age-related wet macular degeneration. Because many residents experience macular degeneration, the safety and expense of Lucentis and an alternative, Avastin, have been of concern to long-term care providers. The drugs also have been linked to a reduction in nursing home admissions related to blindness.

The American Medical Association and other groups protested the data release. The said it could be too easily misunderstood by the public, because people do not understand how Medicare works and are likely to be suspicious of doctors who seem to bill for excessive reimbursements. While some highly paid doctors — including Melgen — have come under federal scrutiny for their billing practices, others pocket a relatively small portion of their Medicare dollars after paying out for pharmaceuticals and other overhead, the AMA said.

Click here to access the complete data set.

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