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News of the Day ... In Perspective

09/1/2006

Medicare pays $275 million for “quality” data that doctors call useless

In an initial step in the Bush administration’s push to get doctors to report important quality measures in their offices, chemotherapy providers were paid $130 each time they assessed a Medicare patient for pain, fatigue, and nausea, and reported results to Medicare. The patients had to pay $26. The top ten billers received more than $270,000 each. One oncologist in Florida billed the government for $625,803. The median amount received was about $23,000.

The Inspector General for the Department of Health and Human Services questioned the integrity of the data.

“We identified numerous anomalies and gaps in the data and collection methods,” writes Daniel Levinson in his report. The report also said that “Most oncologists did not believe [the program] would lead to quality improvements for patients or produce any useful research findings.”

Medicare officials defended the program, saying it showed the feasibility of getting doctors on a large-scale basis to report quality data. About 90 percent of eligible providers participated.

“We’re trying to go from a system that is completely blind to what goes on in the doctor’s office to one that is highly informed and very helpful to the practicing doctor and to the beneficiary through transparency and quality measures,” stated Dr. Peter B. Bach, a senior advisor at the Centers for Medicare and Medicaid Services (Kevin Freking, AP 8/29/06).

Sen. Charles Grassley (R-IA), Chairman of the Senate Finance Committee, said the taxpayers were “bilked.”

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