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Thursday, April 10, 2014

Federal data show big Medicare payouts for dozens of N.J. doctors

More than two-dozen New Jersey physicians were among hundreds nationwide that took in millions from treating Medicare patients, according to a massive release of federal data on Wednesday that shines a light — some say unfairly — on the doctors giving the most expensive care to the elderly.

In what it called an effort to increase transparency on government spending on health care, the Centers for Medicaid and Medicare Services released for the first-time a breakdown on Medicare spending by physician. Patient advocates say the information will allow the public to gauge how well the government monitors doctors who are generating the highest bills.

But physician groups said the data are apt to be misinterpreted because they don’t explain the often-complicated method the federal government uses for reimbursing doctors. The data, long lists of physician names and their total Medicare claims in 2012, will target some providers for closer scrutiny from federal auditors even though the high bills could be for justifiably expensive care rather than a sign of fraud or waste.

“This data is skewed,” said Dr. Michael Harris, an ophthalmologist whose practice, NJRetina has 14 locations in central and northern New Jersey.

Harris, who is listed in CMS data as having billed Medicare more than $3.8 million in 2012, said the gross reimbursement amounts listed for retinal specialists like himself do not take into account the fact that much of the money is...

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