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Medicare Reimbursement: Top SD Doctors

April 30, 2014, 6:19 PM by Casey Wonnenberg

Medicare Reimbursement: Top SD Doctors

Last night's HealthBeat told you about five South Dakota doctors and the big checks they received in Medicare reimbursements. 

One thing you may have noticed: all of the doctors on the list were either ophthalmologists or oncologists.

An ophthalmologist working at Black Hills Regional Eye Institute is number 2 on the list for Medicare Part B-Fee-For-Service reimbursements in 2012. Another ophthalmologist was also in the top five in South Dakota.

"Ophthalmology uses a medication that's very expensive for macular degeneration," South Dakota State Medical Association President Dr. Dan Heinemann said.

South Dakota State Medical Association President Dr. Dan Heinemann says expensive medications make a big difference in how much doctors are reimbursed.

"That doesn't mean they're keeping the money. It means they're the ones who tend to use the very expensive drugs that their patients need," Mike Fierberg from the Centers for Medicare and Medicaid Services said.

Another specialty that tends to have patients who need expensive medications is oncology. Dr. Richard Conklin, who works as a cancer specialist in Aberdeen, topped the list of South Dakota doctors reimbursed by the federal government. He was paid more than 6-million dollars in 2012.

"Many of these medications, especially the chemotherapy drugs, can be very expensive. The newer ones are very expensive," Heinemann said.

Physicians in such specialties usually purchase the medications before they are administered, which is why their Medicare reimbursements tend to be so high. Heinemann says in addition to Dr. Conklin's specialty, his location also makes a difference.

"Dr. Conklin has been a solo provider of those services in that community with a fairly wide range of service--up into North Dakota and eastern South Dakota--so he is going to have a lot of Medicare-age patients in his practice," Heinemann said.

In a statement to KELOLAND News, the doctor holding the number 3 spot, Opthamologist Dr. Eric Thomas, says his specialty has a high percentage of patients who use Medicare and that common and expensive diseases occur in that age group.

"Cataracts are only seen in the elderly. Everybody has two eyes, so that's two cataracts," Heinemann said.

Which may explain why doctors in certain specialties tend to be reimbursed more for Medicare.

If you would like to know exactly how much South Dakota doctors were reimbursed just click on this link.

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