April 14. 2014 9:12PM

NH doctors: There's more to Medicare list than meets the eye

New Hampshire Union Leader

A Portsmouth eye doctor who started a 15-doctor practice received $1.89 million in Medicare payments in 2012, more than any other physician in New Hampshire, according to an expanded list of physicians and other health care providers who bill Medicare.

Eye doctors and ophthalmology practices — as well as ambulance services — received some of the highest dollar payments under Medicare Part B in New Hampshire, according to data released last week by the Centers for Medicare and Medicaid Services.

The list in today's New Hampshire Union Leader (see Page A8) shows the top 100 providers among the 5,300 who billed Medicare and received payment in 2012. A list that ran in the New Hampshire Sunday News, which contained correct information, was based on incomplete data.

Physicians said the list by itself gives no context.

A doctor may be on the list because he actively accepts Medicare patients, while other physicians refuse Medicare and Medicaid because of low payments, said Dr. David Goldberg, a Manchester cardiologist. Or the physician may be popular.

"This may mean the guy's the best in his craft," Goldberg said. And the list would not include pediatricians, whose patients are not eligible for Medicare.

He said the list puts the data in isolation and allows for no interpretation.

Others were happy to see the data released. The national AARP, for example, said the data could be used to help determine physician performance and could help reduce Medicare fraud.

"These numbers definitely begin to make consumers think about utilization of procedures in the Medicare program," said Ariel Gonzalez, a spokesman for the AARP. He said the AARP wants the CMS to make the data easier to understand. The organization favors the release of more information, such as how often a provider uses certain procedures and expensive medications.

The New Hampshire list shows eight providers topping the $1 million mark in billings for the year.

The top physician was Dr. Richard Chace, the founder of Eyesight Ophthalmic Services in Portsmouth. Chace's $1.89 million came from 11,918 separate Medicare services he billed during the year. Three other physicians in the practice also landed in the top 100 list.

A telephone message left Monday for Chace and an email sent to his practice were not returned.

Ophthalmologists comprise more than one-third of the top 100 on the list. The American Academy of Ophthalmology said eye doctors treat a lot of Medicare patients because older people suffer from diseases of the eyes.

Ophthalmology practices have some of the highest overhead costs, including staff, technology and equipment, the academy said on its website. And eye doctors, unlike others, must include costly drugs in their Medicare bills, and pass the payments through to drug companies.

"Ophthalmologists support sharing data to advance improved patient outcomes and care, but drawing conclusions from this data is anything but transparent or easy," said Dr. David W. Parke II, chief-executive of the American Academy of Ophthalmology.

Medicare is a federal government health program, paid for through payroll taxes, that provides health care to the elderly and disabled.

The data released last week entails only payments for Medicare Part B, which pays for services provided outside a hospital setting and that require a patient co-pay. Medicare Part B payments to New Hampshire providers exceeded $276 million for 2012, according to the data.

The single highest-paid provider on the list is the Merrimack-based CarePlus Ambulance Service, which received $2.62 million. Executive Vice President Rick Doherty said the bills involve 911 calls as well as rides between hospitals and nursing homes.

CarePlus has eight locations in New Hampshire. Medicare pays about $210, plus mileage, for a basic ambulance ride.

"We're the largest ambulance transport company in the state. We would expect to be at the top," Doherty said.

The incomplete Sunday News list placed cardiologist Goldberg among the top 50 billers in the state. He fell off the complete list, which runs in today's newspaper. Goldberg said he received a lot of negative reaction.

"Most physicians are honest workers and are open to transparency," Goldberg said. "The problem comes when you have to spend time to defend yourself."