The Department of Health and Human Services inspector general has uncovered $22 million in payments made to doctors who attempted to defraud the Medicare program by billing HHS for services and treatments they did not perform.
Despite the fact that multiple cataract surgeries on the same eye are “medically impossible,” Medicare paid $8.6 million for more than 10,000 such procedures in 2012.
“This includes one provider whom Medicare paid $59,455 for 69 surgeries — the most of any provider — on eyes that already had cataracts removed,” the IG said.
The program shelled out $14 million for claims that were specifically banned under federal guidelines and $8 million for claims banned under local ones, the report said.
Most of the 46,456 providers who filed ophthalmology claims in 2012 received no potentially fraudulent payments, the report noted. Only 237 received questionable payments of $10,000 or more, and only 12 took home $100,000 or more of such payments, the report said.