Medicare to open physician payment data; organized medicine wary
Physicians’ and patients’ privacy rights and health care quality are at stake if the federal government poorly implements a new policy allowing for public disclo- sure of Medicare physician payment data. That was the warning the Texas Medical Association, the American Medical Asso- ciation, and roughly 100 other state and national medical specialty societies sent to Medicare officials as they developed the new rule, set to take effect March 18. The Centers for Medicare & Medicaid
Services (CMS) announced in January that it will evaluate freedom-of-infor- mation requests for individual physician
payment information on a case-by-case basis. The new rule has been in the works since May 2013, when a U.S. dis- trict court judge in Florida dissolved a 1979 injunction that barred Medicare from releasing physician payment data on the grounds that doctors’ privacy rights outweighed the public interest. Offering no details, CMS says it will
“weigh the balance between the privacy interest of individual physicians and the public interest in disclosure of such in- formation.” The agency itself also plans to compile and make publicly available aggregate data on Medicare physician services, CMS Principal Deputy Admin- istrator Jonathan Blum said in a Jan. 14 blog post.
The new decision “takes into account [the Department of Health and Human Services’] strong commitment to greater data transparency over the past several years. … As part of this effort, CMS has engaged with a wide range of public,
nonprofit, and private sector stakehold- ers to foster the availability and use of health care data to drive innovations that improve health and health care,” Mr. Blum said. Organized medicine cautioned, how- ever, that CMS must walk a fine line.
“We believe these efforts to release Medi- care physician data are appropriate, rec- ognizing that they serve to enhance the quality of our health care system and in- clude safeguards. The unfettered release of raw data, however, could easily result in inaccurate and misleading informa- tion that could ultimately undermine the quality of care for patients,” the physician groups wrote in a comment letter. “Publication of reimbursement information for any purpose and with- out appropriate safeguards would move toward an opposite extreme — it would categorically dismiss significant privacy interests and would fail to ensure that the data can be used in a truly effective manner. Such broad, indiscriminate dis- closure of personal financial information would undermine the careful balance that presently exists in existing laws and regulations that recognize the interests between public disclosure and the pri- vacy of physicians and patients.” TMA, AMA, and other physician orga- nizations urged Medicare officials to fo- cus on data releases that seek to improve health care quality, ensure the accuracy of the data they release, and monitor any public reporting of the information to guard against potential abuses that could harm physicians’ reputations or livelihoods. Mr. Blum said CMS takes those con- cerns seriously. “As CMS makes a deter- mination about how and when to dis- close any information on a physician’s Medicare payment, we intend to con- sider the importance of protecting physi- cians’ privacy and ensuring the accuracy of any data released, as well as appropri- ate protections to limit potential misuse of the information. And as always, we are committed to protecting the privacy of Medicare beneficiaries.” n
Amy Lynn Sorrel is associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
34 TEXAS MEDICINE March 2014
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