CMS Issues Proposed Rule on Transparency of Medicare Claims Data - June 14, 2011

The federal Centers for Medicare & Medicaid Services (CMS) on June 8 published a proposed rule to grant qualified entities with access to patient-protected Medicare claims data so that such entities may evaluate the quality and cost performance of hospitals and practitioners. The rule will codify Affordable Care Act provisions that require the U.S. Department of Health and Human Services to begin providing access to such Medicare Parts A, B and D claims data in 2012. Entities that receive access to such information must pay a fee to cover the cost of providing the data and must already have access to claims data from other sources to help create a more complete analysis of provider performance. Further, the entities must use the data only to evaluate provider and supplier performance and to develop reports that can help consumers identify hospitals and providers based on quality and cost data. Qualified entities would have to demonstrate they have sufficient measures to treat the Medicare claims data securely and the finalized public reports must be aggregated data, so patient-specific information will not be identified. Comments on the proposed rule are due by Aug. 8.