Doctors who lose licenses still collect from Medicare

Several doctors who have committed medical malpractice and other offenses to such a degree that they lost their state licenses to practice medicine have been able to practice medicine in other states and to continue billing Medicare for their services.

A Bloomberg News investigation found seven doctors who billed Medicare for a total of $6.5 million in 2012, despite having lost their medical licenses because of medical malpractice or other misconduct.

Consumer advocates and some members of Congress decried what they called a permissive approach to participation by doctors in the $604 billion Medicare program. Records show that all seven doctors informed Medicare that they had lost their licenses.

The information was released by the Centers for Medicare and Medicaid Services (CMS), which administers Medicare. The federal agency released data regarding its payments to doctors for the first time in more than 30 years. So far, only data from 2012 has been released. CMS said it hoped the release of data would make it possible for others to assist in uncovering fraud within the system.

CMS has discretionary authority to take doctors off the Medicare provider list if they lose their state license to practice medicine. The Department of Health and Human Services (DHS) Inspector General has the same discretionary authority. Neither agency is required to act, and a DHS spokesman said that doctors are generally not excluded if one state revokes a medical license but another state grants a license with knowledge of the first state’s action.

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