Seven R.I. doctors got more than $1M from Medicare in 2012

Seven Rhode Island physicians are among 4,000 doctors and organizations nationwide who received at least $1 million in Medicare reimbursements in 2012, according to an unprecedented and controversial set of data released this week. More

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Seven R.I. doctors got more than $1M from Medicare in 2012

DATA RELEASED by the Center for Medicare and Medicaid Services showed that seven Rhode Island physicians were among those nationwide who received more than $1 million in Medicare Part B reimbursements in 2012.
Posted 4/11/14

PROVIDENCE – Seven Rhode Island physicians are among 4,000 doctors and organizations nationwide who received at least $1 million in Medicare reimbursements in 2012, according to an unprecedented and controversial set of data released this week.

The data also show that with $12.5 million in reimbursements, Dominion Diagnostics LLC

Clinical Laboratory in North Kingstown was the state’s largest beneficiary of Medicare Part B reimbursements in 2012.

That company was followed by East Side Clinical Lab Inc. in East Providence, at $7.1 million and Med Tech Ambulance Service Inc. in Pawtucket, at $4.6 million.

The highest-earning physician on the list ranks fourth overall. Anesthesiologist Dr. Fathalla Mashali received $3.7 in reimbursements for treating 727 patients.

Mashali and Dr. Jonah Litch, a Providence internist who received $3.17 million in reimbursements on 652 patients, were the only two Rhode Island physicians to receive more than $3 million in payments, the data indicate.

Last year, the inspector general of the Department of Health and Human Services recommended that Medicare establish a practice of automatically reviewing billings when they exceed $3 million annually.

Other Rhode Island doctors who received payments of $1 million or more from Medicare included:

  • Dr. John Przygoda, a Warwick hematologist and oncologist who received just over $1 million for treating 503 patients

  • Dr. Harold Woodcome, a Providence opthalmologist, who received $1.02 million for seeing 610 patients

  • Dr. Daniel Esmaili, a Providence opthalmologist, at $1.2 million for more than 1,000 patients

  • Dr. Robert Janigian, a Providence opthalmologist, at $1.2 million and 707 patients

  • Dr. Magdelena Krzystolik, a Providence opthalmologist, with $1.2 million for seeing 845 patients

Other organizations at or above $1 million in paybacks were: Universal Ambulance Service Inc. in Providence, at $1.9 million; Professional Ambulance of Providence, at $1.9 million; the city of Providence, which saw $1.7 million come back to its ambulance services; New England Ambulance Service Inc. in Johnston at $1.8 million; and Candescent Eye Surgicenter in Warwick, at just over $1 million.

All told, $260 million in Medicare Part B reimbursements made their way to the Ocean State in 2012 - out of $77 billion in total reimbursements nationwide - the data show, with hundreds of doctors, clinics and health care providers all receiving payments through the system.

While physicians groups had expressed concern about how the data would be interpreted, the American Medical Association decided against a last-minute court challenge against the report’s release.

The Center for Medicare and Medicaid Services released the data, saying it hoped that analysis of it would prove helpful in efforts to control health care costs.

“Data transparency is a key aspect of transformation of the health care delivery system,” CMS Administrator Marilyn Tavenner said. “While there’s more work ahead, this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.”

Nationally, release of the data also shed light on a relatively small number of participants in the Medicare program, including a Florida physician who received $21 million in reimbursements.

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