Public Release of Medicare Claims Data Raises Some Concerns

Under a proposed rule recently published by the Centers for Medicare and Medicaid Services (CMS), physicians would have the opportunity to review claims data reports and ask for corrections about their data before the reports on physician performance are released to the public.  

The Medical Group Management Association (MGMA) says that consistency of measurements among providers is one of the concerns it will outline in comments to CMS by the Aug. 8 deadline.

The rule, which would allow public and private qualified entities to receive Medicare claims data reports as required by the Affordable Care Act, provides instructions regarding the release and use of the data. The reports, combined with private-sector claims data, are designed to help educate the public on physician performance.

MGMA also plans to seek clarification on the definition of a qualified entity. A qualified entity has been defined as a public or private entity that qualifies, as determined by the Department of Health and Human Services, to use claims data to evaluate the performance of providers and suppliers on quality, efficiency, effectiveness, and resource use.

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Last Updated: 7/1/2011
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