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Insights

Jan 17, 2014

CMS to Disclose Physician Payment Data

Published

Jan 17, 2014

On Jan. 14, HHS announced that it will begin responding to Freedom of Information Act requests for physician-payment information.

The disclosure of specific Medicare physician reimbursement data was banned until last year, when a Florida federal judge ruled on May 31, 2013, that physician privacy concerns do not outweigh the overall public interest in releasing the data. CMS will make case-by-case determinations on the release of physician-payment data based on the potential harm to physician privacy versus the public interest in data transparency. The identities of individual Medicare patients will not be released with these data disclosures under any circumstances.

In addition, the House Ways & Means and Senate Finance Sustainable Growth Rate (SGR) bills include provisions for physician payment transparency.  Both bills would require CMS to post on the Physician Compare website the number of services furnished and the charges and payments by eligible providers. If the legislation passes, this provision would be implemented in July 1, 2015, for physicians and the following year for other providers.  

This new physician payment policy will provide greater transparency of Medicare data.  In 2013, CMS began posting charge data for both inpatient and outpatient procedures, data on hospital spending, and quality of care. This type of information would likely help providers and payers identify trends in healthcare utilization and fraud.  It also may allow patients access to new information about their physicians and better understand their out-of-pocket costs.

CMS will begin publishing data about Medicare physician services on March 7, 2014.

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