U.S. to Let Public See How Medicare Pays Doctors.

[elleng]

Source: nyt/reuters

The Obama administration announced on Wednesday that it will for the first time reveal how much Medicare pays individual doctors for medical services and procedures, including MRIs and CT scans.

The U.S. Department of Health and Human Services (HHS) will release on April 9 massive amounts of data on more than 880,000 individual doctors and other health professionals in all 50 states who participate in Medicare's Part B fee-for-service program, which covers physician fees and out-patient services.

The information, which includes doctors' names and addresses and summaries of their services, had been barred from public release by court injunction for more than 30 years until last May when a federal judge in Miami lifted the ban in response to a motion by Dow Jones, publisher of the Wall Street Journal.

The American Medical Association, the flagship lobby group for doctors, had fought against lifting the injunction. On Wednesday, it urged the administration to allow doctors to review and, if needed, correct the information on their practices before the data is released to the public.

Read more: http://www.nytimes.com/reuters/2014/04/02/us/02reuters-usa-healthcare-doctors.html?hp

[DontTreadOnMe]

1. How dare us taxpayers ask to see the bill?

I want to see the list of doctors who complain they don't make enough...

[bossy22]

2. I'm guessing you believe doctors are overpaid?

[lumberjack_jeff]

17. Why should it be a matter of belief?

I'm sure that the AMA is fighting tooth and nail to keep the information secret because doctors will be ashamed of how poor they actually are.

[Kelvin Mace]

19. Has not a damned thing to do with that

it has to do with taxpayers being allowed to see how their money is spent.

Of course, I doubt that doctors are very anxious for folks to find out that the CT-scan they were just billed $2500 for, cost Medicare $400.

And you know what, the median wage for a GP is $176,530 according to the BLS, which puts there income higher than 94% of the rest of the country. Is that too much? Actually, in my opinion, no it is not. But damned if that exempts them from disclosing what they charge the taxpayer for their services.

[sendero]

37. The entire pricing system..

... for almost all medical services would enrage most Americans if they had the slightest clue how it worked. It is a gigantic scam.

[loudsue]

38. No truer words were ever spoken.

It is a racket. Nothing less than a racket.

[LuckyLib]

50. Exactly. And it has been allowed to exist precisely because most Americans were

"covered" and never saw a detailed bill. Medical insurance -- a criminal enterprise.

[DontTreadOnMe]

24. I'm guessing you like to guess what other people are thinking?

what are you hiding?

[passiveporcupine]

25. Funny thing is

I've never seen a poor doctor or dentist. They all live pretty damn well around here, and I live in an upscale area...even if I am not upscale myself.


How much do you think doctor's should be paid?

[Sarah Ibarruri]

3. Actually... I work in a field in which I get to see bills submitted and payments by Medicare...

and I've seen payments of $2.00. Yes, you heard it. $2.00. For services. By physicians.

[bossy22]

10. our medical billing system is so fucked up in this country

[Sarah Ibarruri]

14. It's pure chaos. We needed to learn from countries with successful medical systems, but instead

we did not.

[Mojorabbit]

16. My husband had a few payments framed that were for .01 and .02 cents. nt

[Sarah Ibarruri]

18. Yet some people think that Medicare pays medical providers "a lot" - hmm... and hey, insurance

companies do something similar. They sit in judgment of medical services, like gods, and determine what they desire to pay.

[passiveporcupine]

26. I am not sure anyone thinks Medicare pays doctors a lot

Maybe just a fairer price than what doctors demand.

[Sarah Ibarruri]

27. 1 cent or $2.00 is not what I'd call a fair price for physician treatment. :) nt

[passiveporcupine]

29. I've never seen that kind of a payment. I'd need to see more details.

Usually it's about 1/3 to 50% of what most doctors charge...depending on whether they are family practice or specialists.

[GeorgeGist]

34. Those are rare outliers ...

As you should know.

[Sarah Ibarruri]

48. Not really. I routinely see billing for $1000 get paid $100, and so on, and not only from Medicare,

but from insurance companies.

Our medical system has been a royal mess. What I don't get is why we never took the high road before and set up a nationwide health system. American right wingers are the worst problem in the U.S.

[Sarah Ibarruri]

28. But insurance companies do something like that, or worse. They sometimes refuse to pay them. nt

[passiveporcupine]

30. Are you a doctor, or married to one?

[Sarah Ibarruri]

31. I have a nephew who is an internist, and I work in a field that, while not medical, allows me

to see medical billing and payments by Medicare and all kinds of insurance.

[passiveporcupine]

32. I guess we all have our own perspective

I've seen the price doctors ask for with my services and the amount that insurance or Medicare pays, and it's pretty unbelievable what they expect people to pay who have no insurance.

I've never seen a payout like you are talking about.

[passiveporcupine]

33. One more point

Doctors do good work and I admire them. But they don't just work for the rich, they work for the poor and they should know that when they sign up for the job. And since many people don't have insurance, is it really fair to charge $500 or more an hour for your time? Because that's what I've seen happening, even for family practice.

Something has to fix this. And it should not be for profit insurance that just adds to the cost.

[Cha]

4. Mahalo Ellen!

[elleng]

5. Hey Cha!

[Cha]

7. Good ol O Admin..

[freshwest]

6. That sneaky Obama is gonna brainwash us into 'Medicare For All.' How dare he? n/t

[Cha]

8. snerk..

fresh~

[Sarah Ibarruri]

15. I think if anything, ACA will solve the problem because we need ASAP to put all this under the same

umbrella. From there, we can begin tweaking it, and improving it.

[cbdo2007]

9. Or you can just access it at this link like always:

http://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx

I use that just about every day for my job. HCPCS codes can be found with a quick search online.

Or you can download the spreadsheets from CMS with all of the data and see them all that day. Why are they saying this was a secret?

[elleng]

11. Dunno.

'had been barred from public release by court injunction for more than 30 years until last May when a federal judge in Miami lifted the ban in response to a motion by Dow Jones, publisher of the Wall Street Journal.'

[a2liberal]

13. I think what they're releasing is data for individual doctors

like what doctors are being paid for what procedures how many times, etc. I'm torn personally... seems prone to right-wing misleading witch hunting

[Sgent]

46. That's the difference

That said, the link above will tell you exactly how much a doctor in Miami (or anywhere) gets paid for a certain procedure. The only thing this adds to the mix is how many procedures and individual doctor does.

[kelliekat44]

12. I hope they show the doctors who commit fraud and abuse of the system. nt

[Dustlawyer]

20. I hope it doesn't discourage doctors from taking

Medicare patients.

[Igel]

52. It might.

Imagine if every recipient of public assistance had their purchase records made public.

"Mrs. Jones, it says here that you received $3,532.29 in public assistance last year, and you only spent $3.13 on fresh fruit. An apple on 3/10/13, two plums on 7/23/13, and 2 pears on 11/23/13. Is that any way to spend your food stamp money for your kids?"

There'd be riots in the streets and some people would say, "Uh, no thank you, I deserve some sort of privacy."

[SoapBox]

21. I would be curious...

I have my 93 year old Mom living with me, so that means appointments every month.

Of her six medical offices (primary, pain, ophthalmologist, macular, cardiologist and podiatrist) there have been two that I replaced, due to their bitch'n (can I say that?) about Medicare AND O-bama...a third one I finally told the office manager to put a muzzle on complaining and to turn off FuksNews in the lobby.

The others never say a word.

All that being said, I want to see billing/payment numbers as we, taxpayers, are just expected to keep our noses out of the doctors/insurance/Medicare's business.

[Sgent]

47. You should

bet getting statements from CMS that give details on all of that.

[kickysnana]

22. Are they putting out the amount billed also? The reimbursement rate is pitiful.n/t

[Nye Bevan]

41. No doctor is forced to participate in Medicare (nt)

[kickysnana]

51. And cherry pie tastes good with ice cream. n/t

[jwirr]

23. Anyone who is on Medicare already knows what the costs are. You get these "bills" that tell you at

the bottom "this is not a bill". It is actually a itemized statement of charges that Medicare has paid. When my mother had surgery the thing was so detailed that every asperin was listed.

[GeorgeGist]

35. Cool story bro ...

But you should have left out the bullshit about 'asperin'.

[Tracer]

36. What bullshit?

I've had bills that run 9 - 10 pages long that not only include the aspirin, but $.10 for a bag of saline.

[Nye Bevan]

40. Me too. They include absolutely everything (nt)

[jwirr]

45. Why should I lie? The hospital charges for anything they give a patient when they are in the

hospital. And I am not a bro. I am a sis.

[RebelOne]

49. I just received one of those "This is not a bill"

statements today. It just showed that the doctor who did the original examination before my eye surgery was paid. But I do not owe anything because a lot of it was out of pocket because Medicare only pays 80%. And if you do not have supplemental insurance, the rest is up to you. And I do not have supplemental insurance because the premium is too high.

[Nye Bevan]

39. Good. It's our money, let's see how it's spent.

And no doctor is forced to take Medicare. Presumably those that choose to do so feel that they are getting a reasonably good deal.

[melm00se]

42. What they get paid

for the services that they provide is only part of the equation.

I doubt that the doctor's costs will be included.

Without both sides of the equation, the information is not overly useful.

[Nye Bevan]

43. I don't think the government would have that information.

But any doctor who wants to make public what his or her costs are is free to do so.

[melm00se]

44. I am sorry I should have expanded on my comment

if a doctor's reimbursement for an office visit is $120 (and I just picked that number of mid air for discussion purposes), that might sound like a lot.

but if their costs are $110 for the same amount of time (office rent, light, gas, water, equipment leases, payroll, insurance and all the other overhead that comes with being a highly educated professional and a small business owner), the perception of the reimbursement changes doesn't it?