CMS Seeks Input Regarding Release of Physician Payment Data

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On August 6, 2013, CMS published a request for public comments regarding the potential release of Medicare data on payments to physicians.  CMS’s proposed policy on the disclosure of physician payment data is intended to increase transparency and stems from a federal district court ruling in May that lifted a permanent injunction originally issued in 1979 that prohibited the Department of Health, Education, and Welfare (now HHS) from disclosing Medicare reimbursement payments made annually to individual physicians.  CMS is now in the process of evaluating when, and in which circumstances, the public interest in disclosure outweighs the physician’s privacy interest in the information.

CMS makes clear that it does not contemplate the public “disclosure of any information that could directly or indirectly reveal patient-identifiable information,” and specifically seeks input on the following:

  1. whether physicians have a privacy interest in information concerning payments they receive from Medicare and, if so, how to properly weigh the balance between that privacy interest and the public interest in disclosure of Medicare payment information, including physician-identifiable reimbursement data;
  2. what specific policies CMS should consider with respect to disclosure of individual physician payment data that will further the goals of improving the quality and value of care, enhancing access and availability of CMS data, increasing transparency in government, and reducing fraud, waste, and abuse within CMS programs; and
  3. the form in which CMS should release information about individual physician payment if CMS chooses to release it (e.g., line item claim details, aggregated data at the individual physician level).

CMS will accept comments until September 5, 2013.  The request for comments is available here

Reporter, Juliet M. McBride, Houston, +1 713 276 7448, jmcbride@kslaw.com.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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