Medicare to Publish Trove of Data on Doctors

Louise Radnofsky in the Wall Street Journal: “The Obama administration said it would publish as early as next week data on what Medicare paid individual doctors in 2012, aiming to boost transparency and help root out fraud.
The move, which faced fierce resistance from doctors’ groups, would end a decadeslong block on making the information public.
Federal officials said they planned to release reimbursement information on April 9 or soon after that would show billing data for 880,000 health-care providers treating patients in the government-run insurance program for elderly and disabled people. It will include how many times the providers carried out a particular service or procedure, whether they carried it out in a medical facility or an office setting, the average amount they charged Medicare for it, the average amount they were paid for it, and the total number of people they treated.
The data set would show the names and addresses of the providers in connection with their reimbursement information, officials at the Centers for Medicare and Medicaid Services said. The agency hasn’t previously released such data.
Physicians’ organizations had sought to prevent the release of the data, citing concerns about physician privacy. But a federal judge last year lifted a long-standing injunction placed on the publication of the information by a federal court in Florida, in response to a challenge from Dow Jones & Co., The Wall Street Journal’s parent company.
Jonathan Blum, principal deputy administrator at CMS, informed the American Medical Association and Florida Medical Association in letters dated Wednesday that the agency would move to publish the data soon.
Ardis Dee Hoven, president of the American Medical Association, said the group remained concerned that CMS was taking a “broad approach” that could result in “unwarranted bias against physicians that can destroy careers.” Dr. Hoven said the AMA wanted doctors to be able to review and correct their information before the data set was published. The Florida Medical Association couldn’t immediately be reached.
Mr. Blum said that for privacy reasons, data related to subsets of fewer than 11 Medicare patients would be redacted.
In the letters, Mr. Blum said the agency believed that news organizations seeking the information—which include the Journal—would be able to use it to shed light on problems in the Medicare program. He also specifically cited earlier reporting by the Journal that had drawn on similar data.
“The Department concluded that the data to be released would assist the public’s understanding of Medicare fraud, waste, and abuse, as well as shed light on payments to physicians for services furnished to Medicare beneficiaries,” Mr. Blum wrote. “As an example, using similar payment information, The Wall Street Journal was able to identify and report on a number of instances of Medicare fraud, waste, and abuse, using Medicare payment data in its Secrets of the System series,” Mr. Blum wrote. That series was a finalist for a Pulitzer Prize in 2011.”