CMS Posts Groups’ Comments on Releasing Medicare Payment Data

Background

CMS issued the request after a federal judge in May lifted a 33-year-old injunction that barred the government from giving the public access to a confidential database of Medicare insurance claims.

The court injunction stemmed from a lawsuit that the American Medical Association and the Florida Medical Association filed to prevent former President Jimmy Carter’s administration from publishing a list of annual Medicare reimbursements.

The database, known as the Carrier Standard Analytic File, contains information on physicians and other health care providers participating in Medicare who are paid on a fee-for-service basis. It incorporates all physician claims that Medicare paid directly.

Federal investigators can use the database to find fraud, but its information on physicians and other individual providers has been kept confidential from the public.

If the agency determines that doctors have a privacy interest related to their Medicare payments, CMS plans to create a review system to balance health care providers’ privacy with public interest (iHealthBeat, 9/13).

Details of Responses

CMS received 248 pages of responses to its request, with most sent by or before the Sept. 4 deadline.

However, the agency waited until last week to publicly post all of the comments online (MedPage Today, 11/1).

In a response to CMS, Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey said the agency should ensure such data are available to “entities that are reasonably experienced with handling data and will partner with CMS in the common goal of achieving high-value care in the public and private sector.”

However, the group did not recommend widespread public release of the data to any interested parties.

Meanwhile, the American Academy of Family Physicians, AMA and other physician-led groups sent a letter to CMS urging the agency to develop data protection policies before releasing such Medicare data.

The group said CMS should “engage with experienced data statisticians, physician organizations and other relevant stakeholders on ways to further protect such data.”

The letter also argues that individual payment data should be presented in conjunction with clinical quality information to facilitate value-based decisionmaking among consumers (iHealthBeat, 9/13).

In a separate letter, the American Medical Group Association urged CMS to account for the various ways in which Medicare payments are made.

American Osteopathic Association told CMS that the release of Medicare data on individual physicians should be delayed until:

Technology is available to ensure data accuracy;

Data are used by consumers for health care decisionmaking;

Transparency requirements do not add administrative burdens to physician practices; and

Physicians have the opportunity to review their data before they are published online and are allowed to add comments.

Meanwhile, the American College of Physician Executives told CMS that a survey of its members found that:

  • 46% were against Medicare payment data being released publicly;
  • 42% supported such a move; and
  • 12% were unsure (MedPage Today, 11/1).

Source for Story:

http://www.ihealthbeat.org/articles/2013/11/4/cms-posts-groups-comments-on-releasing-medicare-payment-data

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