CMS Proposes New Rule Allowing Access to Medicare Data for Reports on Providers

CMS has proposed a new rule that would grant organizations that meet certain qualifications access to patient-protected Medicare data, in order to produce public reports on physicians, hospitals and other healthcare providers. These reports would be a combination of Medicare claims data and private-sector claims, identifying which physicians and hospitals provided the highest quality, cost-effective care to patients.

The data will be used solely to evaluate provider and supplier performance and generate public reports detailing those results. The CMS will only release reports that include aggregate information, which means individual patient and beneficiary information would not be shared or made available.

The proposed rule does not list any specific organizations that will have access to the data, instead giving the HHS secretary discretion to establish criteria to determine whether an entity is qualified to use the data. The proposed rule will be published in the Federal Register on June 8, and CMS will accept public comments for 60 days following that date.

For more information on how to avoid potential adverse consequences that could result from a review of your Medicare data, please contact Robert S. Iwrey at (248) 996-8510 or visit the HLP website.