Medicare made $77 billion dollars in payments to doctors during 2012. For the first time ever, information about these direct payments has been made available to the public.
The data shows a few doctors received millions of dollars in payments. Several dozen healthcare providers were recipients of payouts of four million dollars or more from the agency. The 100 doctors with the most funding saw a total of 610 million dollars.
The Centers for Medicare and Medicaid Services made the data available to the general public for the first time in history.
More than three-quarters of all direct payments made to doctors in 2012 by Medicare were sent to just 25 percent of medical professional enrolled in the program. A majority of payments were for 214 million routine office visits.
Release of the data was opposed for years by the American Medical Association. They claimed release of the information would violate privacy rights of doctors.
Salomon Melgen, an ophthalmologist from North Palm Beach, Florida, was the top recipient of funding from Medicare. In 2012, the 59-year-old doctor obtained $21 million in funding from the Federal insurance program. Much of this funding was in the form of reimbursements for a drug called Lucentis, used to treat macular degeneration. That prescription drug is made by Genentech, which supplies funding to doctors who order the medicine for patients.
Majority PAC, a political action committee operated by supporters of Senate majority leader Harry Reid, received $700,000 from Melgen. The PAC spent $600,000 supporting the re-election of Senator Robert Menedez from New Jersey. The 60-year-old lawmaker is a close personal friend of the eye doctor, according to the New York Times. In 2013, the senator used jets owned by Melgen for travel to the Dominican Republic.
Medicare was designed to provide health coverage to senior citizen and people with certain medical disorders. For the first time, the American public knows who is profiting.
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According to the Burrill report, In the United Kingdom, where Novartis markets Lucentis, the drug is the most commonly used treatment for wet AMD. It costs nearly $1,100 (£700) per injection. Avastin, which is marketed by Roche, costs about $92 (£60) per injection. Both are equally effective. Ophthalmologists often use Avastin, which is not approved as a treatment for the disease, as an off-label treatment because it is significantly less expensive. The findings are in line with a similar National Institutes of Health study, known as the “CATT” trial, results of which were announced in April 2012. One can infer from this cost disparity of the mutually beneficial economics at play between drug companies and medical professionals when doctors endorse the solely approved expensive treatments.