The release of Medicare payment data to doctors is intended to tell the public how many patients an individual doctor treats, and what the government paid for the care—information that could shed light on physicians' competence in certain procedures as well as show patterns of fraud and overuse.
For the past 35 years, CMS officials have considered it a violation of physicians' right to privacy to tell the public how much Medicare pays individual doctors. But a federal judge in Florida ruled last year that doctors' privacy rights no longer trumped the public interest in making the data public. The decision followed the publication of news stories that used Medicare billing data to pinpoint physicians doing suspiciously high levels of Medicare work.
The Florida ruling set the stage for the case-by-case balancing test that CMS is launching today, under which it will consider requests for physician-identifiable Medicare data and determine whether the public's right to know the information outweighs the physician's right to privacy under an exception to the Freedom of Information Act.
“The outcomes of these analyses may vary depending on the facts of each case,” CMS said in a Federal Register notice. “However, in all cases, we are committed to protecting the privacy of Medicare beneficiaries.”
In September, the CMS will begin publicly posting for the first time data showing how much money drug companies, devicemakers and other healthcare suppliers pay to doctors. The data will include almost any “transfer of value,” whether it's a $200 Mont Blanc pen, a $2,000 steak dinner or a $20,000 speaking engagement.
Those disclosures follow increasingly probing data available through CMS' Physician Compare website, which is phasing in publicly searchable information on individual physician's quality of care.
Both the Physician Compare changes and the industry payment data release were mandated by the Patient Protection and Affordable Care Act.
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