Port Washington resident Tom McGinty, a data reporter for The Wall Street Journal, was part of the team that was awarded a Pulitzer Prize in the investigative reporting category for their “Medicare Unmasked” series that exposed abuses in the Medicare system. The winners were announced on April 20 and it was the first time The Wall Street Journal won in the category since it was created in 1985.
The series used Medicare billing data released to the public only after a legal fight that began in 2009, when the paper’s legal team started a lengthy battle with the federal government to get the data from the Medicare billing system. The system had kept the billing data of healthcare providers private since 1979, due to doctor privacy rights. In 2013, the Center for Medicare and Medicaid Services released data that showed the dollar amounts provided by Medicare reimbursements to doctors and medical providers.
The subsequent reporting in The Wall Street Journal series exposed abuses that were defrauding American taxpayers of $60 billion each year. Stories from the series also shed light on those who were committing fraud, leading to congressional inquiries and legal charges.
According to investigations editor Michael Siconolfi, a Manhasset resident, the size and scope of the project required members of the newspaper’s investigative staff, healthcare bureau, legal and graphics teams to contribute.
“Like any team, you need great chemistry [among] everyone,” he said. “It was great to see coordination [by] everyone. Reporters are working 24/7 on this, and just because we got accolades doesn’t mean we can stop, because this is important to the public.”
The Medicare billing data is massive, considering the fact that the system covers Americans across the country, so data reporters joined the investigative staff to comb through the vast amount of information to look for outliers and general trends. Healthcare reporters then used their expertise in the field to analyze findings and report on specific cases of fraud.
Having been a finalist for stories on Medicare in 2010, the staff’s past reporting in the field made them well-positioned to handle the data once it was released, according to McGinty. “It’s great, really exciting. Every journalist wants this because it’s the pinnacle as a journalist,” he said.
For Health and Science Bureau Chief Stefanie Ilgenfritz, the series provided more for Americans than the exposure of fraud in Medicare. The release of the billing data meant more transparency in the relationship between U.S. citizens and their government.
“This one was particularly sweet. We struck a blow for FOIA [Freedom of Information Act], not just for us, but for everyone,” Ilgenfritz said. The act is a mechanism that allows people to ask the government to release information and documents to the public that might not be readily available otherwise.
Siconolfi hopes that the reporters at The Wall Street Journal and other media outlets can continue to keep a check on the system through similarly effective reporting. With the template for impactful collaborative reporting set by the series, he hopes they can replicate the series’ effect.
Siconolfi, Ilgenfritz and McGinty all indicated that receiving the award didn’t mean they could take a break. If anything, the series indicates that the Medicare system could use more attention. “It was hugely impactful,” they agreed, “and we’re still continuing to cover this because the data will be released every year now.”
