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Story By Tim Fought
Published on Saturday April 16, 2011 - 12:52 PM
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PORTLAND, Oregon - Regulators in Oregon are requiring a mentor will begin reviewing the operating decisions of a Portland neurosurgeon who figures in a Wall Street Journal investigation of Medicare billing and multiple spinal surgeries on the same patient.

The Oregon Medical Board released an agreement Friday it said was necessary while it completes an investigation of Dr. Vishal James Makker. He signed the order.

The board said it got "credible information" this year about four patients but gave no other details.

It did not refer to two recent stories in the Wall Street Journal that have said Makker's name "popped up" when it searched the Medicare claims database for surgeons who performed multiple spinal fusions on numerous patients.

The Journal has reported that Makker had the highest rate of multiple spinal-fusion surgeries among 3,407 surgeons who performed the procedure on 20 or more Medicare patients in 2008 and 2009.

In those years, the paper said, he did spinal fusions on 61 patients, and for 16 performed a total of 24 additional fusions.

He denied wrongdoing, telling the paper he acted in the best interest of the patients and attributing multiple surgeries to failures of spinal implants and referrals from doctors who don't accept Medicare patients.

He said he is "the dumping ground for Medicare patients, especially the difficult ones that everyone knows are going to be difficult to fix with one or even two surgeries."

In some cases, he said, patients require separate surgeries on different parts of their spines.

He didn't immediately return calls Friday from The Associated Press.

The Journal stories describe a series of malpractice claims, including one settled with a 62-year-old man who'd been operated on six times in two years, and say he has lost his operating privileges at Portland Providence Medical Center.

In a statement, the hospital said he "is not currently practicing at Providence Portland." It said it couldn't reveal details of any review process but said revoking privileges could be a result of a review of complaints.

According to the Medical Board's records, it proposed in 2006 to take disciplinary action against Makker for violations that included "excessive billings" and "medically unnecessary procedures."

But it stopped short of discipline with a "corrective action order" in which Makker neither admitted nor denied wrongdoing and agreed to steps such as a medical association review, auditing of his billing and taking a course in billing. The board said in 2009 he had complied with the conditions and lifted the order.

The board's records also document insurer payments of $500,000 and $275,000 in malpractice suits in recent years. One suit was settled without an insurance payment, the records show.