Doctors continue to get million$ from Medicare after their licenses yanked

SouthernNM H&V Group

The first time cardiologist Robert Graor lost his Ohio license to practice medicine was in 1995, after he was convicted of 10 felony theft counts for embezzling more than $1 million from the Cleveland Clinic and sentenced to three years in jail.

The second time was in 2003, after he’d won back the license following his release from prison. This time, the Ohio Board of Medicine found he repeatedly misrepresented his credentials over a two-decade period and permanently barred him from practicing medicine.

That didn’t stop Graor from participating in Medicare, the government’s health insurance program for the elderly and disabled. In 2012, Medicare paid $660,005 for him to treat patients in New Mexico, which gave him a license to practice in 1998. Graor declined to comment…

At least seven doctors who’d lost a medical license because of misconduct collected a total of $6.5 million from Medicare in 2012, according to federal data. The list includes doctors accused of gross malpractice, a brutal sexual assault and violating prescription drug laws. Their continued participation in the $604 billion program reflects what some members of Congress and others call a permissive approach that lets providers with questionable backgrounds keep billing taxpayers. All the doctors notified Medicare of the loss of their licenses, records show…

CMS has “discretionary authority” to ban a doctor from the Medicare provider list if his license to practice has been revoked by a state, spokesman Aaron Albright said in an e-mail. The agency would not reveal if it has taken any action against the providers identified by Bloomberg as having lost their licenses to practice, saying such a disclosure would be a violation of the doctors’ privacy.

The U.S. Department of Health and Human Services Inspector General also can ban a doctor from Medicare if a state has revoked a medical license. Like CMS, it isn’t required to do so. Donald White, an agency spokesman, says the revocation of a license falls into a “permissive area where they will not necessarily be excluded” from Medicare. He said doctors are “generally not excluded” in cases where one state has pulled a license but another allows that doctor to continue practicing, with the knowledge of the first state’s action.

In all seven cases identified by Bloomberg, the doctors stripped of a license in one state were allowed to practice in another state and continued to bill Medicare.

RTFA for all the gory details. Graor is practicing cardiology, etc. down in Deming, New Mexico. Wonder if folks know – or care – about his history. I wonder why the Feds consider doctor’s privacy a higher priority than patient safety. A doctor who lost his license twice.

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