Upper endoscopies may bilk Medicare

Research study results raise the question of whether some gastroenterologists do upper endoscopies to make money servicing Medicare beneficiaries who show no signs of illness on their first exam, Forbes reported. Often performed as an outpatient procedure, an upper endoscopy involves running a thin scope with a light and camera at its tip down the throat to check inside the upper digestive system for signs of serious illness. A study in the Annals of Internal Medicine analyzed data on almost 1 million randomly selected beneficiaries who had upper endoscopies between 2004 and 2006. Fifty-four percent of those who underwent the tests shouldn't have had them, the study found. With the average cost of the procedure estimated at $3,000, the projected Medicare overpayment is $1.2 billion for 4 million unnecessary services performed nationwide during a three-year period, Forbes estimated. Article

 

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