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B-164031(4) 1 (1970-09-30)

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                COMPTROLLER GENERAL OF THE UNITED STATES
                          WASHINGTON, D.C. 20548
0 RESTRICTD, -   Not to be released outside the General
   Accoi; t'- - i flce except oni the basis of -   appreval
   by the 1L Vice of Legislative ULiso~i, a  -   . oi which is kept
             rbution Section, Publications .ra ..ch, OAS
B- itX4uj (4)'2       70


Degr M.r. Chajirman:


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     30 -  7


EP 30 1970

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      Pursuant to your request of May 7, 1970 (enc. II), we are submit-
ting a report (enc. I) on our review o Medicare payments made by the
Massachusetts Medical Service (Blue Shield) for the services of super-
visory and teaching physicians at the Massachusetts General Hospital
in Boston, MassachusettS3 These payments were made under the Sup-
plementary Medical Insurance Benefits for the Aged (part B) portion of
the Medicare program.

      This is the second report submitted pursuant to your May 7 re-
quest. A prior report concerning Medicare payments for the services
of salaried supervisory and teaching physicians at -erman Kiefer Hos-
pital in Detroit, Michigan, was submitted to the Committee on Au-
gust 21, 1970.

      The Medicare program is administered by the Social Security Ad-
ministration (SSA), Department of Health, Education, and Welfare, which
has entered into contracts with various private insurance companies,
such as Blue Shield organizations, for making benefit payments for phy-
sicians' services under part B.

      Following is a summary of the,_j btained during our
review at the Massachusetts General Hospital, relating to the points of
interest specified in your letter of May 7.

      --During the period October 30, 1967, through September 30,
        1969, Blue Shield paid about $296,000 to the hospital under
        part B of the Medicare program for the services of supervi-
        sory and teaching physicans who were affiliated principally with
        the Harvard Medical School. The billings by the hospital were
        on a fee-for-service basis in the names of specific physicians
        for specific services provided to specific Medicare patients who
        were inpatients in the teaching service section of the hospi-
        tal. (See pp. 2 to 9.)

      --Our review of the hospital medical records applicable to se-
        lected Medicare patients treated in the teaching service section


9136


,EtEASED


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