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This site is the inspiration of a former reporter/photographer for one of New England's largest daily newspapers and for various magazines. The intent is to direct readers to interesting political articles, and we urge you to visit the source sites. Any comments may be noted on site or directed to KarisChaf at gmail.

Thursday, April 10, 2014

Doctor-Pay Trove Shows Limits of Medicare Billing Data -- Figures Don't Capture Complexity of Some Medical Practices -- By Christopher Weaver, Melinda Beck and Ron Winslow, The Wall Street Journal

The trove of Medicare data released Wednesday shows a wide cast of characters in the top ranks of the highest-reimbursed doctors, and reveals as much about the limits of the newly public billing records as it does about medical practice.

Among the highest-reimbursed doctors in their fields were a Michigan oncologist with $10 million in 2012 payments and a Rhode Island anesthesiologist at $3.5 million, both of whom have been indicted for fraud in federal courts. Also among the highest reimbursed was Jean Malouin, a family-medicine doctor in Michigan, but that is because she reimburses other doctors in a special demonstration program backed by the agency that oversees Medicare. The Michigan oncologist has pleaded not guilty. An attorney for the anesthesiologist says his client is innocent. 

That diversity underscores crucial gaps in the new data. Medical groups and policy makers have asserted that the figures lack context needed to show which doctors may be abusing the system and which are simply hard workers and overseers of complicated medical practices, or those whose specialties involve high overhead costs, such as radiation oncology, that lead to bigger bills. 

The government disclosure spurred doctors on Wednesday to defend and explain their practices in detail usually obscured from public view. 

"This public release will create enormous social pressure to be cautious about being an outlier," said Peter J. Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine in Baltimore. "No physician is going to want to be labeled as that person who is billing $20 million."

 The disclosure of the data came after a lengthy legal battle by Dow Jones & Co., publisher of The Wall Street Journal, to overturn an injunction that had prevented the government from publicly releasing Medicare payment information on individual doctors.

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