Medicare Spending Data May Be Publicly Available Under New Policy by Gavin Baker.
From the post:
On Jan. 14, the Centers for Medicare & Medicaid Services (CMS) announced a new policy that could bring greater transparency to Medicare, one of the largest programs in the federal government. CMS revoked its long-standing policy not to release publicly any information about Medicare’s payments to doctors. Under the new policy, the agency will evaluate requests for such information on a case-by-case basis. Although the impact of the change is not yet clear, it creates an opportunity for a welcome step forward for data transparency and open government.
Medicare’s tremendous size and impact – expending an estimated $551 billion and covering roughly 50 million beneficiaries in 2012 – mean that increased transparency in the program could have big effects. Better access to Medicare spending data could permit consumers to evaluate doctor quality, allow journalists to identify waste or fraud, and encourage providers to improve health care delivery.
Until now, the public hasn’t been able to learn how much Medicare pays to particular medical businesses. In 1979, a court blocked Medicare from releasing such information after doctors fought to keep it secret. However, the court lifted the injunction in May 2013, freeing CMS to consider whether to release the data.
In turn, CMS asked for public comments about what it should do and received more than 130 responses. The Center for Effective Government was among the organizations that filed comments, calling for more transparency in Medicare spending and urging CMS to revoke its previous policy implementing the injunction. After considering those comments, CMS adopted its new policy.
The change may allow the public to examine the reimbursement amounts paid to medical providers under Medicare. Under the new approach, CMS will not release those records wholesale. Instead, the agency will wait for specific requests for the data and then evaluate each to consider if disclosure would invade personal privacy. While information about patients is clearly off-limits, it’s not clear what kind of information about doctors CMS will consider private, so it remains to be seen how much information is ultimately disclosed under the new policy. It should be noted, however, that the U.S. Supreme Court has held that businesses don’t have “personal privacy” under the Freedom of Information Act (FOIA), and the government already discloses the amounts it pays to other government contractors.
The announcement from CMS: Modified Policy on Freedom of Information Act Disclosure of Amounts Paid to Individual Physicians under the Medicare Program
The case by case determination of a physician’s privacy rights is an attempt to discourage requests for public information.
If all physician payment data, say by procedure, were available in state by state data sets, local residents in a town of 500 would know a 2,000 x-rays a year is on the high side. Without every knowing any patient’s identity.
If you are a U.S. resident, take this opportunity to push for greater transparency in Medicare spending. Be polite and courteous but also be persistent. You need no more reason than an interest in how Medicare is being spent.
Let’s have an FOIA (Freedom of Information Act) request pending for every physician in the United States within 90 days of the CMS rule becoming final.
It’s not final yet, but when it is, let slip the lease on the dogs of FOAI.