Medicare Posts More Payment Data on Individual Physicians

May 10, 2016

It's one more milestone in Medicare history that physicians probably don't want to celebrate.

The program last week published online what individual physicians, nurse practitioners, physician assistants, and other clinicians received in fee-for-service (FFS) payments during 2014, the third annual data dump of its kind.

The public-use data allow anyone to look up submitted charges and payments for Medicare Part B services and procedures by clinician. The dataset for 2014 covers more than 986,000 clinicians who received $91 billion in Medicare payments, compared with 950,000 clinicians who received $90 billion in 2013.

The Centers for Medicare and Medicaid Services (CMS) enhanced the data this time around by adding a so-called Medicare standardized payment amount. It removes geographic differences in reimbursement rates for individual services based on the likes of local wages and input prices, making payments across the nation comparable.

The government had wanted to reveal what individual clinicians received from Medicare as far back as the 1970s, but a federal judge issued a permanent injunction against such a move in 1979, saying it violated a privacy law. However, another federal judge in 2013 lifted the injunction, over the objections of the American Medical Association (AMA) and other medical groups. That court decision led to the first release of payment information, covering 2012, in the spring of 2014.

When Medicare followed up with its second annual data dump last year, then-AMA president Robert Wah, MD, repeated his association's criticism that the payment information did not shed light on quality of care, thus opening the door for misinterpretation. This year's data release came and went without any comment by the AMA.

More information on the release of Medicare payment data for individual clinicians in 2014 is available on the CMS website.

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