Medicare To Disclose Physician Reimbursement Data

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 “For the first time in decades, HHS may start telling the public exactly how much money individual doctors earn treating Medicare patients.”

By Joe Carlson

For the first time in decades, HHS may start telling the public exactly how much money individual doctors earn treating Medicare patients.

 

Previously, the release of specific Medicare physician-payment data was banned because it was deemed an invasion of physician privacy. But last year, a federal judge in Florida ruled that doctors’ privacy concerns did not trump the public interest in disclosing the information, which can be used for detecting trends in healthcare utilization and fraud, among other things.

 

On Tuesday, HHS announced that it would begin responding to Freedom of Information Act requests for physician-payment data. The agency didn’t guarantee every request would be filled, but said government officials would begin using a “balancing test” to determine which information should be released.

 

The Freedom of Information Act’s privacy exemption may still shield some information from public view if the damage to physician privacy is judged greater than the public interest in the information. In no case would such disclosures reveal the identities of individual patients.

 

“As the outcome of the balancing test will depend on the circumstances, the outcomes of these analyses may vary depending on the facts of each case,” HHS said in the rule (PDF). “However, in all cases, we are committed to protecting the privacy of Medicare beneficiaries.”

 

Under the new policy, which becomes effective 60 days after it appeared in the Federal Register, the CMS will also begin publishing “aggregate” data sets about Medicare physician services.

 

Both changes are part of an overall move in the direction of greater data-transparency at Medicare, officials said, including the first-ever release of Medicare charge data for inpatient and outpatient procedures last year and previously unpublished information on hospital spending and quality of care. Much of the data is on www.healthdata.gov.

 

The agency reviewed more than 130 comments from 300 organizations on the new physician-payment policy before announcing the final rule, under which data release decisions will be made on a case-by-case basis.

 

“Given the advantages of releasing information on Medicare payment to physicians and the agency’s commitment to data transparency, we believe replacing the prior policy with a new policy in which CMS will make case-by-case determinations is the best next step for the agency,” CMS Principal Deputy Administrator Jonathan Blum wrote in a blog post Tuesday.

 

Follow Joe Carlson on Twitter: @MHJCarlson

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