Industry News

CMS Seeks Public Comments on the Release of Medicare Physician Payment Data.

Jennifer Kirchner | August 2013

The Centers for Medicare & Medicaid Services (CMS) seeks public input regarding potential disclosure of individual physician payment data.  This proposed initiative was motivated by CMS’ commitment to greater data transparency.  The initiative was also prompted by a recent legal development in which a court lifted a permanent injunction originally issued in 1979 that prohibited the disclosure of annual Medicare reimbursement payments to individual physicians.  The decision to vacate the injunction demonstrates support for a broad public interest in transparency with respect to government services, which the court found outweighed physicians’ individual privacy interests.  CMS cites other changes to Medicare that support the disclosure of individual physician payment data including:

  • A public interest in the information due to the substantial growth of Medicare.
  • Changes to the Medicare reimbursement system resulting in standardization of payment amounts.
  • The creation of the Qualified Entity program, a data sharing program that allows for the production of public performance reports.
  • The greater consequences of Medicare fraud, waste, and abuse.     
  • The ongoing research, assessment, and evaluation of programs and services to improve the delivery, quality, and cost of care.

CMS seeks public comments as it considers the appropriate policy regarding release of physician payment data.  CMS seeks comments with regard to:

  • Whether physicians have a privacy interest with respect to information concerning Medicare payments they receive and, if so, how to properly balance physician privacy interests and the public interest in disclosure.
  • What specific policies CMS should consider with respect to disclosure of individual physician payment data that will further the goals of improving the quality and value of care, enhancing access and availability of CMS data, increasing transparency, and reducing fraud, waste and abuse.
  • The form in which CMS should release information about individual physician payment data.

CMS will accept public comments via e-mail, U.S. mail, or hand delivery through September 5, 2013. 

The CMS request for public comments on the release of Medicare physician payment data is available at:

http://downloads.cms.gov/files/Request-for-Public-Comment-rePhysician-Data-8-6-2013.pdf.

Centers for Medicare & Medicaid Services.  “Request for Public Comments on the Potential Release of Medicare Physician Data.”  Press Release.  6 Aug. 2013.

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.