Beware of this medical scam that puts thousands of older patients at risk

Outrage doubled

You know, it’s one thing if you want to scam Medicare. I don’t condone it, but I get it.

Doctors feel underpaid, nickel-and-dimed…so they try to bilk the system to get what they think they are entitled to.

Ok…not all doctors, but some doctors.

Regardless, my point is that if you want to steal from Medicare, find a way to do it without putting the patients that trust you in grave danger. Because that makes you more than a criminal. It makes you downright evil.

X-rays for days

Imagine if your doctor told you he needed to take 700 X-rays of your chest.

Even the most timid, trusting patient would probably speak up with two questions:

1) Are 700 X-rays really necessary?

2) Won’t that expose me to a dangerous amount of radiation?

The answers, of course, are 1) No, and 2) Absolutely!

But if your doctor told you he needed to do a double CT scan of your chest — one using an iodine contrast to examine blood flow and one scan without the iodine — you might simply go along with the plan. After all, he’s the doctor. He knows best.

That’s exactly what’s happening with thousands of patients every year.

Now here’s the disturbing reality:

* A double CT scan is almost never necessary (the rate of double scans compared to single scans at major university teaching hospitals is about one percent)
* Medicare pays out millions of dollars every year to cover unnecessary second scans
* Two CT scans deliver the same amount of radiation as 700 standard chest X-rays
* Exposing patients to that level of radiation is very dangerous, but doing it unnecessarily is wildly unethical and the illustration of evil

In recent years, the Center for Medicare and Medicaid Services (CMS) has taken steps to alert hospitals, radiologists, and doctors to the high rates of unnecessary double CT scans.

In a few days, CMS will release CT scan statistics for 2009. Those who have already seen the stats say the double scan rates are essentially unchanged, and the scam rages on.

Some hospitals that were previously out of control have brought their double scan rates down to the level of five percent or lower, which is where they should be. But according to the New York Times, a number of hospitals continue to have rates as high as 80 percent. And more than 200 hospitals used double scans on at least 30 percent of Medicare outpatients.

Judging from the Times article, these hospitals aren’t held accountable in any way. Apparently the only repercussion is a poor report from the annual CMS review, which stings just a little bit less than a mild slap on the wrist.

As is so often the case, we can’t wait for someone at Health and Human Services or Congress to step in and take control. Please forward this article to anyone you know who relies on Medicare and has cardiovascular problems that might require a CT scan.

And most importantly, never be afraid to ask detailed questions about any medical procedure or test that seems odd or fishy. Trust your intuition and get answers before agreeing to anything — especially if radiation is involved.

Sources:
“Medicare Claims Show Overuse for CT Scanning” Walt Bogdanich and Jo Craven McGinty, New York Times, 6/17/11, nytimes.com

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