The Centers for Medicare and Medicaid Services expects soon to publicly post Medicare payment information on more than 880,000 healthcare professionals in all 50 states.
With this data, it will be possible to conduct a wide range of analyses that compare 6,000 different types of services and procedures provided, as well as payments received by individual healthcare providers, Jonathan Blum, CMS principal deputy administrator, writes in a blog posting. The data covers $77 billion in payments in 2012 for services delivered under the Part B fee-for-service program. Medicare in 2013 began publishing charge data submitted by individual hospitals.
As part of an initiative to increase government transparency, CMS in January announced it would begin releasing information on amounts paid to individual physicians under the Medicare program, but only on a case-by case basis.
Now, through the blog and in letters to the American Medical Association and Florida Medical Association, CMS is explaining its rationale for a big data dump that will start no earlier than April 9. The agency received multiple Freedom of Information Act requests following the January announcement and has determined that FIOA requires it to make frequently requested materials available electronically after it has been reviewed. This letter notifies you that CMS has decided to publicly release certain physician payment information on its Web site, because CMS has determined that the FOIA requires CMS to release that information, the agency told the medical associations.
Data to be released includes types of medical services and procedures furnished, payment and charge data related to the services and organized by the National Provider Identifier and Healthcare Common Procedure Coding System code, and whether the service was furnished in a facility or office setting. For each NPI/HCPCS code/place of service combination, this public data set will include number of services, average submitted charges and standard deviation in submitted charges, average allowed amount and standard deviation in allowed amount, average Medicare payment and standard deviation in Medicare payment, and a count of unique beneficiaries treated, according to the letter to the associations. Personally identifiable information about beneficiaries will not be released, nor will data that represents fewer than 11 beneficiaries.
CMS however, also has decided to allow researchers to use its data as we are permitted to do under the applicable routine uses in our Privacy Act systems of record notices, according to the letter. This would include the removal of the prohibition on researchers re-disclosing physician-identifiable information. As with the public release of information described above, CMS will continue to protect beneficiary privacy and generally prohibit the release of patient-identifiable information.
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