Is Michael Jackson’s doctor disqualified from Medicare? Or are two senators mistaken?

Introduction

The Obama Administration is disputing claims by two Republican senators that Michael Jackson’s physician mistakenly remained eligible to bill Medicare long after being convicted for his role in the singer’s 2009 death. But the lawmakers aren’t backing down.

Sens. Orrin Hatch, R-Utah, and Tom Coburn, R-Oklahoma, on Tuesday sent a letter to Medicare’s administrator alleging that Jackson’s doctor, Conrad Murray, and at least 34 other convicted felons and unlicensed physicians remain listed as legitimate physicians on the health plan’s provider database. Murray was convicted of involuntary manslaughter in November, which the Senators said should have caused him to be immediately kicked out of the program.

Centers for Medicare and Medicaid spokesman Brian Cook said the senators are mistaken. Conrad’s “enrollments have been revoked and deactivated, and the latest that he billed Medicare was in 2010,” Cook said. The spokesman declined to comment further about the other doctors the senators mentioned in the letter, or to shed light on the precise day when Murray was pushed out of the program.

So far, the senators are not buying the CMS explanation.

“Not only did CMS fail to address any of concerns Senator Hatch or Dr. Coburn repeatedly raised, they failed to remove Dr. Murray from CMS’ provider database,” said Julia Lawless, a Republican press secretary at the Senate Finance Committee. To back up that allegation, Lawless pointed to the public Medicare ordering and referring report, which CMS says is used “to verify that an individual physician or eligible professional has an approved enrollment record.” Dr. Murray is on that list, which was last updated on November 21, 14 days after his conviction. “The reality is, CMS did not take the necessary action to remove Dr. Murray from its provider database, until November 30th, the day after they received our letter,” Lawless said.

Cook did not did not return calls requesting a response to the legislators’ latest assertion.

Both CMS and the Office of Inspector General at the Department of Health and Human Services have authority to remove physicians from the Medicare program. Don White, a spokesman for the OIG, said the office has not yet barred Murray. But since the doctor has been sentenced, he now faces mandatory exclusion as soon as the office receives formal notice of conviction from the court. White did not know how long that would take. “There is a process in place,” White said, “and it is functioning and the outcome for Dr. Murray will be decided based on that due process.” White said all excluded providers have 30 days to appeal the exclusion.

In the Senator’s Tuesday letter, they cite a lack of communication between CMS, state agencies, and federal law enforcement as one cause of the problem.

“In a time of increased technological capability,” they wrote, “it appears CMS is disconnected. Without data sharing agreements with its law enforcement partners, we fear CMS will remain in the dark and Medicare beneficiaries will be placed at risk.”