Report: Examine high-billing docs' Medicare billing to root out fraud

Dec 23 2013

A report from the Department of Health and Human Services' inspector general to be released Friday will call for closer scrutiny of doctors' total billing. Elsewhere, ProPublica looks at how ineffective federal oversight is in looking for fraud in Medicare prescribing.

The Wall Street Journal: Medicare Auditors Urged To Check Doctors' Total Billing To Prevent Fraud
Flagging doctors who bill more than $3 million a year could help prevent overbilling and save Medicare millions of dollars each year, said the report set to be released Friday by the inspector general at the Department of Health and Human Services. Obama administration officials said they were considering implementing the report's suggestions as part of efforts to root out Medicare fraud (Schatz, 12/20).

ProPublica: 'Let The Crime Spree Begin': How Fraud Flourishes In Medicare's Drug Plan
With just a handful of prescriptions to his name, psychiatrist Ernest Bagner III was barely a blip in Medicare's vast drug program in 2009. But the next year he began churning them out at a furious rate. Not just the psych drugs expected in his specialty, but expensive pills for asthma and high cholesterol, heartburn and blood clots (Weber and Ornstein, 12/19).

And officials hope to ease restrictions on Medicare telemedicine --

Medpage Today: Medicare To Expand Telemedicine Use
Medicare officials and members of Congress are taking steps to expand the use of telemedicine services by dropping -- or proposing to drop -- restrictions on their use. Both the 2014 Medicare physician fee schedule and legislation to repeal the program's sustainable growth rate (SGR) payment formula have provisions designed to improve access to telemedicine (Pittman, 12/19).