On Wednesday, the federal government released a massive trove of Medicare data showing how much some 880,000-plus U.S. healthcare providers were paid for their services in 2012. Fully mining the data will take months or years, but using the data to compile a list of the top Medicare billers took mere minutes.
Texas doesn't have any villains quite as convenient as Dr. Salomon Melgen, a West Palm Beach ophthalmologist who both received $21 million in Medicare payments and looks vaguely sinister in pictures, but it does have its fair share of doctors and lab that annually bill the federal government for millions of dollars.
The Wall Street Journal, among others, has put the data into a searchable database, which allows sorting by state and city.
Topping the list in Texas are clinical labs like Quest Diagnostics, whose Irving and Houston locations received a combined $80.2 million, and Laboratory Corporation of America, whose Dallas and Houston locations were paid a combined $74.9 million. Houston's Proton Therapy Center is the first non-lab on this list, coming in at No. 9 with $8.7 million in Medicare reimbursements. Rounding out the top 10 is the city of Houston's ambulance service, which gets $8.7 million. Here's the list:
And what doctors and practices, outside of labs and ambulance services, are the most prolific? Hundreds received more than $1 million from Medicare. Here are Texas' top 25:
None of this is to imply that any of these providers are doing anything wrong. There are plenty of reasons for a high Medicare reimbursement rate, like treating a lot of elderly patients. As the New York Times notes, this is highlighted by ophthalmologists, who comprise roughly half of the top 100 billers nationwide.
In ophthalmology, for example, a small number of doctors are able to perform high numbers of well-paid cataract surgeries or give numerous injections to patients with a serious eye disease known as macular degeneration, a condition that can, if left untreated, lead to blindness. They are also likely to treat a large share of Medicare patients in their practices.
"There are just these pockets of profitability within the system," said Dr. Lisa Bielamowicz, executive director and chief medical officer for research at the Advisory Board Company.
Ophthalmologists say that their high representation among the list of big recipients is misleading. Much of what Medicare pays them, they say, goes to the cost of the drugs they administer to patients in their offices and the bulk of that money ultimately goes to the drug companies.
Keep the Dallas Observer Free... Since we started the Dallas Observer, it has been defined as the free, independent voice of Dallas, and we would like to keep it that way. Offering our readers free access to incisive coverage of local news, food and culture. Producing stories on everything from political scandals to the hottest new bands, with gutsy reporting, stylish writing, and staffers who've won everything from the Society of Professional Journalists' Sigma Delta Chi feature-writing award to the Casey Medal for Meritorious Journalism. But with local journalism's existence under siege and advertising revenue setbacks having a larger impact, it is important now more than ever for us to rally support behind funding our local journalism. You can help by participating in our "I Support" membership program, allowing us to keep covering Dallas with no paywalls.