Factbox: Using the data on Medicare's payments to doctors

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Factbox: Using the data on Medicare's payments to doctors

By Sharon Begley and M.B. Pell NEW YORK (Reuters) - Medicare billing data released by the federal Centers for Medicare and Medicaid Services (CMS) gives the public an unprecedented look at how the program pays medical providers. In practice, some medical practices and labs file Medicare claims under a single NPI assigned to one of their members, said Karthik Balakrishnan, senior vice president of fraud solutions and analytics of Verisk Health, which specializes in healthcare data: doctors can bill under a group NPI, a hospital NPI, or a clinic NPI, he said. That was the case with a pathologist at the Mayo Clinic in Rochester, Minnesota, who is listed as receiving $11 million from Medicare for 23 million lab tests in 2012, the fourth-highest amount in the country. Dr Franklin Cockerill, he said, "is a salaried employee of Mayo Clinic and is not making big money off Medicare." "More than one person can file under one NPI, including nurses, physician assistants, and other team members," AMA president Dr Ardis Dee Hoven said in an interview.

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