BusinessHealth Reform

Medicare Data Access Provides Payment Transparency

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It’s got bipartisan support, and it would call for transparency the amount that Medicare pays providers for treating patients. Sens. Wyden (D-MA) and Grassley (R-IA) are introducing the Medicare Data Access for Transparency and Accountability Act [link, here]. Its passage into law would override an existing 1979 proviso that keeps such numbers confidential. The original intention of such a law is out of step with the tenets of reform and the new bill’s introduction is a welcome sight in the race to combat Medicare fraud. It is interesting to note that the current injunction has languished for over thirty years — its origins resulting from the obligations of a Florida district court on behalf of the AMA and that state’s medical association to keep such data secret. The AMA still has that position, arguing that release of providers’ Medicare billing info violates privacy in this area and amounts to a form of identity theft. A pretty weak argument when one considers the reason for transparency in this situation: last year the WSJ ran a series of articles highlighting physicians receiving payments in the millions for running unnecessary testing, surgeries, and procedures on Medicare beneficiaries based upon access to limited Medicare claims data. | Sen. Grassley’s statement here | LINK 2

  1. The law would provide information on how much individual physicians receive from Medicare for treating seniors on a FFS basis — expensive level-4 office visits, procedures, etc. — would be posted online.
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