Since 1979, a court injunction has blocked access to Medicare records that would reveal which doctors are bilking the $500 billion system. Yesterday, Dow Jones & Company, the Wall Street Journal's parent company, sued to overturn the injunction, which the American Medical Association won 31 years ago, according to a Dow Jones press release.
"It is time to overturn an injunction that, for decades, has allowed some doctors to defraud Medicare free from public scrutiny," Mark Jackson, Dow Jones' general counsel said in a statement. "The public has a significant interest in learning whether doctors are fleecing the system, the extent of the problem, and whether the government has been effective in stopping such abuse."
The injunction last year limited a WSJ Medicare fraud investigation to a subset of data. And the government released the limited subset only after the Journal agreed not to reveal the identities of individual doctors in the databases.
In response to Dow Jones' move, the president of the American Medical Association worried that the public might draw incorrect conclusions if the data were released. "Physicians, like all Americans, have the right to privacy and due process, and should not suffer the consequences of having false or misleading conclusions drawn from complex Medicare data that has significant limitations," AMA President Dr. Cecil Wilson said in a statement. He also suggested that physicians who care for Medicare patients already are subject to plenty of oversight.
But the WSJ has suggested that contractors aren't doing enough to ferret out improper claims and prevent Medicare from paying more to unscrupulous providers. What's more Sen. Chuck Grassley (R-Iowa) has slammed CMS for not holding contractors accountable for digging up improper payments.
To learn more:
- read the Dow Jones press release
- read the statement from AMA's president
- here's the Wall Street Journal story
- read the Associated Press story
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