By Charles Fiegl, amednews staff. Posted June 20, 2011.
Washington - Qualified organizations would gain access to Medicare billing data for the purpose of developing physician report cards for the public under a new proposed rule from the Centers for Medicare & Medicaid Services.
The health system reform law authorized the limited release of Medicare claims data to outside organizations meeting certain qualifications. The organizations would merge Medicare billing data with private insurance information to compile quality, efficiency and performance information on doctors, hospitals and other health care professionals, said CMS Administrator Donald M. Berwick, MD, in a statement accompanying the rule's release on June 3.
Only qualified entities would gain access
The proposed regulation sets restrictions on who would qualify for access to the Medicare claims data.
Qualified organizations would be required to incorporate private claims data with the Medicare data when developing reports. CMS is considering a mandate that recipients have claims data from two or more other sources besides Medicare, such as private insurers and Medicaid.
"We believe that a requirement for claims data from two or more other sources may help further alleviate some of the methodological issues associated with performance measurement based on single-sourced data," CMS said.
How to comment on making billing data public
The Centers for Medicare & Medicaid Services will accept comments until Aug. 8 on the proposed rule to allow qualified entities access to individual physicians' Medicare billing data for research purposes.
Comments can be submitted online by following the instructions for submitting comments at www.regulations.gov. Enter keyword CMS-5059-P for the document file code.