While most doctors spurn the Medicaid program because of low fees, a select few manage to pull in millions of dollars each year by running high-volume practices.
Ten doctors in Illinois were paid at least $1 million a year from the health care program between 2009 and 2011, according to a Crain's analysis of state payment records.
The totals for some of the highest-paid physicians are boosted by payments for services performed under their supervision.
For example, Dr. Jack Garon, head of pathology at the safety-net Sinai Health System in Chicago, received $5.9 million, more than any other doctor, Crain's found. He is one of four hospital pathologists among the highest-paid doctors in the program because they submit claims for thousands of tests done by labs.
Dr. Sam Lipshitz was the second-highest biller, receiving nearly $5 million before the state stopped payments in 2011 amid an investigation by the inspector general of the Illinois Department of Healthcare and Family Services. The Skokie urologist is one of two doctors in the top 10 who have been the subject of probes into billing practices. The other, the medical director of Planned Parenthood of Illinois, last week reached an agreement to settle claims of billing irregularities.
The department's efforts to crack down on error and fraud are likely to be tested in 2014, when about 800,000 Illinois residents become eligible for Medicaid under the federal overhaul of health care.
Statewide, 225 physicians received at least $1 million from 2009 through 2011. The annual median Medicaid reimbursement for all doctors was between $8,000 and $9,000, Crain's found.