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Taxpayers spending millions on eyelid lifts, as Medicare surgery claims surge

The number of Medicare-billed surgeries for a procedure that lifts droopy eyelids reportedly has tripled since 2001, raising questions about whether doctors and patients have found a way to skirt Medicare's ban on funding cosmetic surgery. 

The insurance program for America's seniors typically doesn’t cover cosmetic surgery. But it does pay for eyelid lifts, known as blepharoplasty, when a patient’s vision is significantly impaired.

The number of eyelid lifts increased three-fold, to 136,000 annually, from 2001 to 2011, according to a review of physician billing data by the Center for Public Integrity.

In addition, the cost to taxpayers increased from $20 million to $80 million over that period, and the number of physicians billing for the surgery more than doubled.

“With this kind of management malpractice, it’s little wonder that the (Medicare) program is in such dire shape,” Sen. Tom Coburn, R-Okla., who is also a physician, told the center. “The federal government is essentially asking people to game the system. Every dollar we spend on cosmetic surgery that isn’t necessary is a dollar that can’t be used to shore up the program for people who need it the most.”

Supporters say the numbers have increased because seniors over the past decade have become more health conscious, which includes fixing medical problem they once suffered through, while critics say the increase is largely the result of the reality-TV fueled desire to look younger. And doctors say patients are putting pressure on them to submit a Medicare claim for the procedure as a result of the cultural phenomenon.

Critics are calling for Medicare to stop potential abuse by requiring pre-authorization for the procedure. Others, though, say that blepharoplasty is not very expensive, with costs ranging from $574 to $640 per eye.