Physician Groups Comment on Medicare Plan to Release Claims Data

The American Medical Association and 81 other physician organizations have submitted comments on a proposed rule published on June 8 to make available standardized extracts of Medicare claims data to measure the performance of providers and suppliers.

The Centers for Medicare and Medicaid Services' rule, covering Medicare Parts A, B and D, is mandated under the Affordable Care Act. Qualified entities may receive the data for the sole purpose of evaluating providers and suppliers and to generate specified public reports, according to the proposed rule. The entities must pay a fee equal to the cost of making the data available, and must combine it with claims data from other sources when conducting evaluations.

The medical associations support much of the proposed rule, but ask for numerous clarifications. For instance, "It is critical that CMS provide standardized specifications for the measures that may be used with Medicare and non-Medicare, private health plan data," according to the comment letter. "This is to ensure that consistent measures and analytics are used in developing public reports that are valid, reliable and actionable." The organizations also urge CMS to consult with key industry stakeholders, including the physician community, to develop standardized and user-friendly formats for public reports on the performance measures.

The associations also call on CMS to ensure physicians can review their data for accuracy and appeal any errors before the information is made public. The complete comment letter is available here.