Analysis: Medicare billing outliers often have disciplinary problems

Propublica, dissecting data released by Medicare on payments made to health professionals in 2012, has uncovered some patterns in the data, the news outlet reported this week. Among its findings: Physicians with unusual billing patterns often have been disciplined by their state medical boards or have faced accusations against their licenses.

Among physicians who almost always billed for the most complex office visits, according to the Medicare data, one Michigan practitioner surrendered his license in New York, agreed not to renew his license in Connecticut, had withdrawn his application for a license in Ohio, and was once on probation in Michigan. Another physician is facing a 2013 accusation by California's medical board for gross negligence in his prescribing of controlled substances, a charge he denies. Both stated that they had charged Medicare appropriately.

Source: Propublica