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HHS to release Medicare physician payment data

January 17, 2014
Area(s) of Interest: Payor Issues and Reimbursement Practice Management 


On January 13, 2014, the United States Department of Health and Human Services (HHS) announced that it would for the first time release physician-payment data in response to Freedom of Information Act (FOIA) requests.


While the agency didn't guarantee every request would be filled, government officials did say they would begin using a “balancing test” to determine which information should be released. The FOIA privacy exemption may still shield some information from the public if the damage to physician privacy is deemed greater than the public interest.


For the past 30 years, provider groups have argued that such data could reveal proprietary details about physicians’ practices and could cause harm to doctors by publishing inaccurate presentations of the data.


The American Medical Association (AMA) has urged the Center for Medicare and Medicaid Services (CMS) to ensure the information is released only for purposed intended to improve the quality of Medicare services and to set appropriate safeguards.


“The disclosure of payment data from government health care programs must be balanced against the confidentiality and personal privacy interests of physicians and patients who may be unfairly impacted by disclosures,” said AMA President Ardis Dee Hoven, M.D.


CMS will begin publishing aggregate data sets about Medicare physicians’ services in 60 days when the new policy goes into effect.


People and groups seeking payment data would have to submit specific requests under the FOIA. HHS has said it will not put the complete Medicare physician-payment database online in a searchable format. According to the rule, published in the Federal Register this week, each request for data will take doctors' personal privacy concerns into account.

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