Doctors billing Medicare for patients' unneeded, expensive tests

Wednesday, November 21, 2012 by: Sherry Baker, Health Sciences Editor
Tags: Medicare, doctors, billing

(NaturalNews) With all the outcry by politicians and the public over skyrocketing healthcare costs, maybe it's time to take a look at how some doctors are running up patients' bills for unneeded tests. A new study just published in Online First by Archives of Internal Medicine, a JAMA Network publication, concludes that diagnostic tests are frequently repeated on Medicare beneficiaries when there's absolutely no compelling medical reason. It seems obvious the only other explanation is for physicians to make more money by billing Medicare numerous times for repeated tests for the same patients.

H. Gilbert Welch, M.D., M.P.H., of Dartmouth College in Hanover, New Hampshire, and colleagues looked at patterns of repeat testing in a longitudinal study of Medicare beneficiaries. In all, they picked five percent of patients' records at random from the 50 largest metropolitan statistical areas.

"We examined repetitive testing for six commonly performed diagnostic tests in which repeat testing is not routinely anticipated. Although we expected a certain fraction of examinations to be repeated, we were struck by the magnitude of that fraction: one-third to one-half of these tests are repeated within a three-year period. This finding raises the question whether some physicians are routinely repeating diagnostic tests," the authors noted in their paper.

For example, among Medicare beneficiaries undergoing an echocardiography to examine their hearts, over half -- 55 percent -- had a second test within three years. Nearly half of imaging stress tests were also repeated in fewer than three years and so were about 50 percent of pulmonary function tests. About 46 percent of those having CT scans of the chest were repeated, 41 percent of bladder examinations by cystoscopy. About 35 percent of the beneficiaries were subjected to repeat upper endoscopies (exams of the digestive tract with a tube) within three years, too.

So what's so bad about this? Frequently repeating these high tech, expensive diagnosis tests in situations when there is no medical need, drives up Medicare costs (although, of course, it can put more money in the pockets of doctors.) But there's also a health risk to patients subjected to over-done testing.

"This has important implications not only for the capacity to serve new patients and the ability to contain costs but also for the health of the population," the authors of the paper concluded. "Although the tests themselves pose little risk, repeat testing is a major risk factor for incidental detection and over-diagnosis." That means people with no health problems can end up being subjected to anxiety over a diagnosis they should never have been given -- to say nothing of potentially dangerous side effects from treatment for a "condition" that is harmless or non-existent.

In an accompanying commentary, Jerome P. Kassirer, M.D., of Tufts University School of Medicine, Boston, and Arnold Milstein, M.D., M.P.H., of Stanford University School of Medicine stated: "After decades of attention to unsustainable growth in health spending and its degradation of worker wages, employer economic vitality, state educational funding and fiscal integrity, it is discouraging to contemplate the fresh evidence by Welch et al of our failure to curb waste of health care resources."

The new report is more evidence of a phenomenon Natural News has reported on in the past --- doctors subjecting patients to inappropriate and downright unnecessary tests, apparently for money. For example, a study by University of California at San Francisco (UCSF) researchers found unneeded, expensive mammograms are being pushed on elderly women who are incapacitated from Alzheimer's disease or other forms of dementia, especially if the women have savings or assets of $100,000 or more.

Sources:

http://archinte.jamanetwork.com/article.aspx?articleid=1392496
http://archinte.jamanetwork.com/article.aspx?articleid=1392495
https://www.naturalnews.com/028095_mammograms_Alzheimers.html

About the author:
Sherry Baker is a widely published writer whose work has appeared in Newsweek, Health, the Atlanta Journal and Constitution, Yoga Journal, Optometry, Atlanta, Arthritis Today, Natural Healing Newsletter, OMNI, UCLA''''s "Healthy Years" newsletter, Mount Sinai School of Medicine''''s "Focus on Health Aging" newsletter, the Cleveland Clinic''''s "Men''''s Health Advisor" newsletter and many others.