On December 5, 2011, the Centers for Medicare & Medicaid Services (CMS) released a Final Rule to implement a provision of the Affordable Care Act (“ACA”) giving qualified entities access to Medicare claims data for use in evaluating the performance of health care providers.

This Final Rule incorporates changes based on public comments to the Notice of Proposed Rulemaking (“NPRM”) published on June 8, 2011. In our report on the NPRM we described how the rule sets forth guidelines on how an organization that meets extensive qualification requirements may pay an annual fee to access patient-level Medicare Parts A, B, and D data. These entities will combine Medicare data with private-sector claims data that they already have access to in order to prepare public reports measuring the performance of physicians, other providers, and suppliers. The goal is to help consumers and payers make informed decisions about their health care by selecting the highest-quality providers in their areas.