Physician Medicare Payments to be Disclosed

Published Online: January 16, 2014
Katie Sullivan
The Department of Health and Human Services (HHS) announced its intention to release Medicare payment data of individual physicians on a “case-by-case” basis. The agency seeks to publicly impart the information following a 2013 federal court decision that overturned an injunction previously barring the release of physicians’ Medicare payments. 

“This notice sets forth a new policy regarding requests made under the Freedom of Information Act for information on amounts paid to individual physicians under the Medicare program in which CMS will make case-by-case determinations as to whether exemption 6 of the Freedom of Information Act applies to a given request for such information,” read the HHS statement.

Although the Centers for Medicare & Medicaid Services (CMS) has been pushing transparency, the agency said that releasing data on a  case-by-case basis will permit it to protect physicians’ privacy as well as verify the accuracy of any data that is released. Jonathan Blum, principal deputy administrator of CMS, said in an official release:

In making the decision to replace the prior policy, the agency considered the more than 130 comments representing the views of over 300 organizations and individuals we received. Numerous of these comments identified ample benefits to releasing Medicare physician payment data, including use of the data by:
  • Providers to collaborate on improved care management and the delivery of healthcare at lower costs;
  • Consumers to gain broader, more reliable measures of provider quality and performance which drives innovation and competition while informing consumer choice; and
  • Journalists and others to identify waste, fraud, and abuse as well as unsafe practices.
Some are advocating the release of all payment data, rather than just on a case-by-case basis. However, the American Medical Association (AMA) said the administration must ensure that practitioner’s privacy rights are secure.

“The disclosure of payment data from government healthcare programs must be balanced against the confidentiality and personal privacy interests of physicians and patients who may be unfairly impacted by disclosures,” said Dr Ardis Dee Hoven, president of the AMA.

Around the Web

AMA fears privacy loss as Medicare moves to reveal doc pay [Modern Healthcare]

CMS Modifies Policy on Disclosure of Physician Payment Information [CMS]

Medicare to Release Doc Pay Data This Spring [MedPage Today]