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CMS to Disclose Physician Payments

Posted On February 19, 2014
February 19, 2014

CMS to Disclose Physician Payments

The Centers for Medicare & Medicaid Services (CMS) which currently covers over 100 Million people through Medicare, Medicaid, the Children’s Health Insurance Program and the Health Insurance Marketplace took the next step towards making Medicare payment data more transparent. The rule, titled “Modified Policy on Freedom of Information Act Disclosure of Amounts Paid to Individual Physicians under the Medicare Program” was passed to increase access for consumers, providers, and journalists in order to identify waste, abuse, and unsafe medical practices.

The January 14, 2014 rule allows CMS to begin responding to requests made under the Freedom of Information Act for physician payment information. Requests will be decided on a case-by-case basis as to whether each specific exemption applies to a request for the payment information under the Freedom of Information Act. With the newly available data, CMS will create and make available “aggregate data sets” for public consumption.

Centers for Medicare & Medicaid Services released the reasoning behind the decision to favor public interest over physician privacy:

  • 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.

CMS Principal Deputy Administrator Jonathan Blum said in a blog posting Jan. 14 “As CMS makes a determination about how and when to disclose any information on a physician’s Medicare payment, we intend to consider the importance of protecting physicians’ privacy and ensuring the accuracy of any data released as well as appropriate protections to limit potential misuse of the information.”

The notice of the policy change was officially published in the Federal Register on Jan. 17 and will take effect at the end of March 2014.

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