Throwback Thursday: In 1983, Government Spent $45M to Clip Toenails
In 1983, the Health Care Financing Administration, now the Centers for Medicare and Medicaid Services, wasted $45 million — $134.5 million in 2023 dollars — by adopting a policy that allowed Medicare to foot the bill for cutting toenails.
Sen. William Proxmire, a Democrat from Wisconsin, gave the agency his Golden Fleece Award for this costly and wasteful policy.
According to Proxmire, “Medicare does not usually pay for routine footcare such as cutting toenails. But if patients have a fungus infection around that toenail, then Medicare will pay for a procedure called debridement of mycotic toenails – in other words, cutting [or removing] infected toenails.”
Proxmire cited an Inspector General report that found “significant overutilization” of this procedure, as well as “solid indications that some podiatrists … are misdiagnosing the medical condition of beneficiaries in order to obtain Medicare reimbursement for routine toenail cutting.” The report cited that these misdiagnoses cost approximately $45 million per year.
A study by the Inspector General detailed the scheme in Virginia. Podiatrists billed Medicare $791,000, with more than 70% of those cases being for debridements. This procedure should take about 15 minutes to complete, but some podiatrists billed for between 50 and 116 debridements in one day’s work, impossible to perform in a single day.
To fix this abuse, Proxmire suggested two simple solutions: limit reimbursements for debridements to once every 60 days, and require doctors to diagnose these infections, not podiatrists. Though simple, those two fixes could have saved taxpayers $45 million in 1983.
Proxmire reminds us that solutions to these problems need not be complicated in order to save taxpayer money.
The #WasteOfTheDay is brought to you by the forensic auditors at OpenTheBooks.com
