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Medicare Reimbursement: Top SD Doctors

April 29, 2014, 6:17 PM by Casey Wonnenberg

Medicare Reimbursement: Top SD Doctors

For the first time in more than three decades, we're getting a better look at how much doctors are being paid for Medicare reimbursement.

The Centers for Medicare and Medicaid released the information as the result of a lawsuit.

The data shows that six South Dakota doctors received more than one million dollars in reimbursement in 2012.

A cancer specialist in Aberdeen, Dr. Richard Conklin tops the list of South Dakota doctors receiving reimbursement checks under the Medicare Part B Fee-For-Service program. In 2012, he was paid more than $6 million.

"It's very easy to misinterpret what it really means," Avera Chief Medical Officer Dr. Tad Jacobs said.

Jacobs says the money received from Medicare doesn't necessarily equal money in a doctor's pocket.

"Labs that were done within the clinic could be billed that way. Various procedures could be billed that way. Medications could be administered that way," Jacobs said.

In other words, there are other costs, not just the doctor's fee, which may be included in any reimbursement from the federal government.

Rounding out the top five for South Dakota Medicare reimbursement are: Dr. Prema Abraham, a Rapid City ophthalmologist who received more than $2.5 million in reimbursements; Dr. Eric Thomas, an ophthalmologist in Sioux Falls whose checks from CMS amounted to more than $1.3 million in 2012; Dr. Anwarul Haq, an oncologist in Mitchell who received more than $1.3 million in reimbursements; and Dr. Kamran Darabi, an oncologist who used to practice in Sioux Falls, who received just over $1 million in Medicare reimbursements in 2012.

All tolled South Dakota's medical professionals, hospitals and clinics received more than $188 million.

The release of the Medicare figures was opposed by the American Medical Association, but a spokesperson for South Dakota's Medical Association says the information could help eliminate fraud in the program.

"If we find somebody who has been inappropriately using the system, they should be dealt with, but we as an Association believe our members provide good care at a reasonable price and are not abusing the system," South Dakota State Medical Association President Dr. Dan Heinemann said.

The release is also part of a push for greater transparency by the White House, which hopes a better-informed patient will become a savvier customer when it comes to lowering health care costs.

"People can see the kinds of payments that are being made and in addition, can see the experience that a given provider may have in using a certain kind of treatment," spokesperson for Centers For Medicare & Medicaid Service Mike Fierberg said.

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