Not quite pill mill, but interesting. I didn't realize some docs (besides onco) were dispensing meds directly, for a big markup of course:
http://www.nytimes.com/2012/07/12/b...llions-selling-drugs.html?_r=2&pagewanted=all
We did not institute this because of the money, Dr. Marc Loev, a managing partner of the Spine Center, a chain of clinics in Maryland, testified last year at a public hearing in Baltimore. We instituted it because we were having significant difficulty providing the care for workers compensation patients.
Uh, yeah.
We do that for WC pts.The amount paid is specified by law, so we get paid less than what the pharmacy would get paid, since the company that administrates the program takes a cut (of course). But it adds to our ancillary income.
Alternatively we can give a pt an Rx, they go down to Walgreens, fill out a form, hand it back in, go home and wait for that form to be faxed to the insurance adjuster, approved and faxed back. That literally can take days in some cases.
I see this as no different than having your own x-ray, MRI, PT, lab, ASC, whatever. If you invest in the infrastructure, why should not the doctor be able to make the money that is going to be spent anyway? Why should it go to a different for-profit company?
Yes, there is the risk of excessive self-referral. In WC, companies will cut you off if they feel you are doing that.
The days of doctors buying yachts off pt exam fees is long gone. E&M collections don't even cover my overhead. Medicare injections under fluoro often pay less than $100. Medicaid in my state is $2B in the red, and 9-12 months behind in payments. All the private companies are starting to require precerts for every procedure and script you write. Get paid for what you do is getting quite challenging.
If it weren't for ancillary income, our overhead would be around 65%. With it, it's less than 20% of collections.
