Some Doctors Continue to Game the System

The Wall Street Journal is at it again.  In the latest installment of its continuing series on the ways in which doctors and hospitals game the Medicare system (“Medicare Unmasked”), it focuses on doctors who charge Medicare for expensive and useless drug tests.  You can find the article here.

In order to combat the overuse and abuse of prescription drugs, Medicare guidelines encourage doctors prescribing pain medication to test their patients to make sure they are not abusing the medications and are taking them as prescribed.  What began as a well-intentioned suggestion was perceived by some doctors as an invitation to rip off the system.

It all starts with a urine sample.  At first these doctors were using paper strips that changed color when exposed to a specific compound in the urine.  They used separate strips for each compound and charged Medicare separately for each of the strip tests.  A single urine sample could turn into many hundreds of dollars of Medicare income.  When Medicare put in place a cap of $20 per urine sample regardless of the number of strips used, the doctors moved on to high tech testing of urine samples with devices such as mass spectrometers for which Medicare has no caps.  As a result, Medicare’s spending on these tests rose to $445 million in 2012, the last year for which figures are available.  This represented an increase of 1,423% over a five year period.  $14 million of that was spent testing seniors over 65 for “angel dust,” a substance which is almost unheard of in that age group.  One pain specialist in North Carolina received $1.4 million from Medicare just for testing the urine of his patients using these exotic devices.  This amount did not count what he received for actually treating his patients.

Doctors like to tell the public that they have to do a lot of tests because of what they call the fear of frivolous medical malpractice lawsuits.  In point of fact, however, some doctors make big money doing tests their patients do not need and which are of dubious medical value.  Keep that in mind the next time the medical profession says you must give up some of your rights in order to keep medical costs down.  Suggest to them that they police their own house to keep costs down before coming to the public and asking for it to sacrifice.

Posted in Doctors, Health Care Costs, Malpractice caps, Malpractice costs, Medical Costs, Medical Malpractice, Medical Negligence, Medicare, tort reform |