Physician Payment Transparency

Overview

On April 9, 2014, the Centers for Medicare & Medicaid Services (CMS) announced the availability of the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File. This newly released data set covers over 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012 from the Medicare Part B Fee-for-Service program.

Physician organizations have long had concerns with releasing Medicare billing information. Since 1979, courts have prevented CMS from publishing the information, yet CMS has given partial data sets to researchers. In June 2013, a federal judge lifted the injunction and in January 2014, CMS modified the administration’s policy on physician payment disclosure and announced that it would evaluate requests for physician payment information.

As a result, CMS received numerous requests for Medicare physician payment information and determined that, in accordance with the Freedom of Information Act (FOIA), it must make frequently requested materials available electronically. Thus, CMS decided to publicly release certain physician payment information on its website.

The AAFP recognizes the potential value of Medicare physician claims data. If used correctly, it can potentially provide accurate and meaningful information to patients, physicians, and other stakeholders that could improve quality at the point of care. 


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