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.
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:
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]
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen