Dr. Milan Vuitch, whose Washington abortion clinic was closed last year after being cited for serious medical deficiencies, received $48,368 from Maryland last fiscal year for abortions performed on poor women, a payment second only to the $75,295 received by a group of doctors affiliated with Johns Hopkins University.
Last year's payments to Vuitch, who was one of 68 doctors and professional associations billing the state for abortion services, accounted for more than 16 percent of the total reimbursements of $289,818.
The latest payments to Vuitch, which total $92,858 for the last three fiscal years, came at a time when state health officials were seeking repayments from him of more than $25,000 for abortions and other medical procedures for which he allegedly had provided inadequate justification, billed too much, or otherwise improperly billed the state.
Vuitch has repaid $12,753.75 of the disputed amount. The state still is seeking repayment of $12,563 for first- and second-trimester abortions and sterilizations.
A spokesman for the state Department of Health and Mental Hygiene said that the department had no power to bar Vuitch from participating in the Medicaid program, despite its findings.
"We cannot terminate a doctor from the program on the basis of inappropriate billing" in the absence of disciplinary action from the state medical board or prosecution for Medicaid fraud, said department spokesman F. DeSales Meyers.
However, he said, Vuitch's wife, Florence, informed the state last November that her husband would no longer participate in the program because he had stopped practicing medicine.
Vuitch's Laurel Clinic was closed under a new emergency law Nov. 27 when the city cited the clinic for medical deficiencies. The clinic had operated for two years without a current license.
Vuitch surrendered his District medical license last December after the D.C. Healing Arts Commission voted to revoke it. The action stemmed from the complaint of a George Washington University doctor who had administered emergency treatment to several abortion patients first seen by Vuitch.
Vuitch remains licensed to practice in Maryland, New York and Virginia. He could not be reached for comment. His lawyer, Melville W. Feldman, declined to comment.
Under current guidelines, Maryland pays for abortions for poor women only in cases of rape, incest or physical danger to the mother, or when the doctor certifies in writing that there is "medical evidence" that the woman's mental health would be seriously affected by carrying the baby to term.
Vuitch has repaid $5,488 for 49 first-trimester abortions he performed in 1980 and 1981 for which the health department said he had provided inadequate justification for the mental health exception.
He also has repaid $6,192.75 for abortions and other services performed from 1982 through 1984 for which he was deemed to have charged excessive fees or charged fees for follow-up visits that the state said should have been covered under the initial fee.
The state also has requested repayments of $13,636 for 91 first-trimester abortions, 12 second-trimester abortions, and 25 sterilizations performed in 1982. Vuitch agreed to repay $1,073. The remaining $12,563 still is pending.