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Among the top surgeons, the data show a South Florida doctor billed Medicare more than $800,000 in 2008 for about 2,200 eyelid lifts. That’s an average of six a day, including weekends.
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Medicare Abuse Raises Eyelids
Washington Free Beacon
Taxpayers footed the bill for over $80 million in cosmetic surgery to make seniors’ eyelids prettier in 2011.

An analysis by the Center for Public Integrity reports Medicare could be paying for medically unnecessary eyelid lifts for thousands of America’s seniors:

The public health insurance program for people over 65 typically does not cover cosmetic surgery, but for cases in which a patient’s sagging eyelids significantly hinder their vision, it does pay to have them lifted. In recent years, though, a rapid rise in the number of so-called functional eyelid lifts, or blepharoplasty, has led some to question whether Medicare is letting procedures that are really cosmetic slip through the cracks — at a cost of millions of dollars. [...]

Surgeons also acknowledge an increased awareness of the surgery fueled by reality television, word-of-mouth referrals, and advertising that promises a more youthful appearance. And doctors concede they face increased pressure from patients to perform eyelid lifts, even when they do not meet Medicare’s requirement that peripheral vision actually be impaired.


A closer look at the numbers suggests fraud is already happening:

Among the top surgeons, the data show a South Florida doctor billed Medicare more than $800,000 in 2008 for about 2,200 eyelid lifts. That’s an average of six a day, including weekends. This same doctor was also a top biller in 2006 and 2007.

By some estimates, Medicare and Medicaid fraud cost the United States taxpayer as much as $98 billion in fiscal year 2011. The federal raid on the offices of Dr. Salomon Melgen, a South Florida eye doctor and friend and donor to Sen. Bob Menendez (D-NJ), threw the spotlight on the issue earlier this year.

READ FULL SOURCE ARTICLE: 05/28/2013








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