The Centers for Medicare and Medicaid Services has issued a proposed rule to make available standardized extracts of Medicare claims data to measure the performance of providers and suppliers.
The rule, covering Medicare Parts A, B and D, is mandated under the Affordable Care Act. Qualified entities may receive the data for the sole purpose of evaluating providers and suppliers and to generate specified public reports, according to the proposed rule. The entities must pay a fee equal to the cost of making the data available, and must combine it with claims data from other sources when conducting evaluations.
Qualified entities would generally be required, with certain exceptions permitted, to use standard measures for evaluating performance. "We believe the sharing of Medicare data with qualified entities through the program and the resulting reports produced by qualified entities would be an important driver of improving quality and reducing costs in Medicare, as well as for the healthcare system in general," according to the proposed rule.
Available now at ofr.gov/inspection.aspx, the rule is scheduled for publication in the Federal Register on June 8.
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