Four doctors in Beaufort County received more than $1 million in payments from Medicare in 2012 and 15 physicians collected more than $500,000, according to data released by the federal government for the first time.
Medicare officials said disclosing physician payment data marks an unprecedented opportunity to make the nation's health care system more transparent for consumers and more accountable to taxpayers. Many consumer advocates and employers applauded the move.
But some Beaufort County physicians and state health care providers said the numbers lack context because they don't reflect the cost of expensive drugs and overhead expenses. The data also don't consider places like Hilton Head Island, where many patients are 65 and older, qualify for Medicare and are more likely to see specialists such as ophthalmologists and oncologists.
"We're not making a killing on Medicare, believe me," said John Brittis, a Bluffton-based rheumatologist who was paid about $1.5 million from Medicare in 2012. "If what you're seeing reflected my take-home pay, I would have retired 10 years ago."
The data, released last week by the Centers for Medicaid and Medicare Services, show 118 Lowcountry doctors who were reimbursed at least $150,000 in 2012 for treating Medicare recipients. In total, physicians in Beaufort and Jasper counties received more than $42 million from the federal program.
Eight of the top 10 most highly reimbursed doctors are located on Hilton Head Island, according to the billing records. An oncologist in Port Royal ranked highest on the list, receiving more than $1.9 million.
The records had been legally blocked since 1979, but recent court rulings removed those obstacles. No personal information about patients is disclosed.
Brittis, the only rheumatologist in Beaufort County, said about 85 percent of his patients use Medicare. He provides treatment for ailments that include arthritis and Crohn's disease.
The medicine is expensive -- Brittis says he spends about $45,000 a week on prescription drugs such as Remicade and Orencia. Medicare covers 80 percent of that bill. A patient's secondary insurance picks up the rest of the tab.
In 2012, Brittis submitted nearly $2 million in charges to Medicare. He was reimbursed for 75 percent, according to federal billing records.
Much of that money went to paying his nurse, his office manager and other overhead costs, he said.
"Doctors know that Medicare reimbursement is low," he said.
On Hilton Head, ophthalmologist Joseph Bishop collected about $928,000 in Medicare payments in 2012, federal records show.
But like Brittis, his clientele is older and more likely to use Medicare to pay for treatment for diseases such as glaucoma and cataracts, according to his billing manager Kathie Ware. Nearly 90 percent of his patients are enrolled in the program, she said.
"Ophthalmology in general is a specialty that deals mostly with the elderly," she said. "Usually the younger crowd goes to an optometrist."
Dermatologist A. Thomas Bundy received nearly $1.2 million, the largest Medicare contribution on Hilton Head. He said his clientele is 70 percent Medicare patients.
"Additionally, given that I am a surgeon, a large percentage of my practice's Medicare reimbursement pays for high practice expenses such as the costs associated with running an ambulatory surgical center, salaries for registered nurses and other overhead expenses," he wrote in an email.
Attempts Tuesday to reach Port Royal oncologist Majd Chahin, who topped Lowcountry doctors in Medicare reimbursement in 2012, were unsuccessful.
An office worker who answered the phone said many of the drugs Chahin uses in his treatments are "quite expensive."
Other health care officials said the records could educate consumers.
The key is comparing costs per patient interaction, said Tony Keck, director of the S.C. Department of Health and Human Services.
With additional crunching of numbers, the data should allow health experts to compare costs between individual practices, between regions or between states, he said.
The release of the records "isn't necessarily 'good' or 'bad' but it helps us understand where the costs are and ask if these costs are appropriate," he wrote in an email.
Follow reporter Dan Burley on Twitter at twitter.com/IPBG_Dan.