Physicians are still trying to understand the

Reimbursement for healthcare services

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Article

Your Payments Become Public Knowledge

Physicians are still trying to understand the implications
of a recent announcement by the Centers for Medicare & Medicaid Services
(CMS) that would allow disclosure of physician-identifiable reimbursement data
to the public.

After 33 years of these data being under lock and key, a
Pandora’s box was opened last May when a federal judge in Florida, Marcia
Morales Howard, invalidated a 1979 federal court decision that prohibited their
use.[1,2]

The change raises all sorts of questions about how the data
might be used. Would physician-rating Websites, investigative reporters, or
malpractice attorneys be given access? Could a practice’s competitors get hold
of it? And would physicians have an opportunity to review and correct the data
before they are released?

Judge Howard’s decision left it up to CMS to formulate
policy, but the agency has been tight-lipped. In an unusually terse notice[3]
published in mid-January in the Federal ter, CMS basically said the data
would be released on a “case-by-case” basis in response to requests.
It added that the program starts in mid-March, but that was pretty much it from
the agency as far as policy details were concerned.

A few more details, however, emerged in a blog post by
Jonathan Blum, Principal Deputy Administrator of the agency.[4] Blum said that
basically, 3 groups — providers, consumers, and investigative journalists —
could access the data, and CMS would apply several criteria. He added that the
agency will “consider the importance of protecting physicians’ privacy and
ensuring the accuracy of any data released, as well as appropriate protections
to limit potential misuse of the information.”

Blum added that CMS would also create its own reports on
physician performance, presumably posting them on its Physician Compare
Website. “CMS will generate and make available aggregate data sets
regarding Medicare physician services for public consumption,” he wrote.
The bill currently in Congress to repeal the sustainable growth rate (SGR) also
directs CMS to compile such information and post it on Physician Compare.

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