CMS Modifies Policy on Disclosing Individual Physician Payment Data

Agency Will Decide Whether to Release Information on Case-by-Case Basis

January 22, 2014 11:51 am News Staff

CMS recently announced that it has modified its policy on the release of information about Medicare payments to individual physicians. Those modifications will allow the agency to determine on a case-by-case basis whether Freedom of Information Act requests for such information should be honored.

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The AAFP weighed in on the topic in early September when CMS requested comments on changing its policy. At that time, the AAFP and a number of other organizations noted that any such change must come with safeguards on the information. "Given the potential for security breaches, hackers or efforts to re-identify information, we urge CMS to consider the potential impact of any data release on patient privacy and engage with experienced data statisticians, physician organizations and other relevant stakeholders on ways to further protect such data," said the organizations in a letter to CMS(8 page PDF).

In response, CMS released the modified policy, which will allow the agency to "evaluate requests for individual physician payment information (or requests for information that, combined with other publicly available information, could be used to determine total Medicare payments to a physician) on a case-by-case basis," said CMS Principal Deputy Administrator Jonathan Blum in a post on The CMS Blog(

Blum noted that CMS received more than 130 comments on its proposed modification that identified numerous benefits from releasing the information. In effect, said Blum, releasing the data would allow

  • health care professionals to collaborate to improve patient care management and deliver health care at a lower cost;
  • consumers to obtain better and more reliable measures of quality and performance for individual health care professionals; and
  • journalists and others to identify unsafe practices, waste and fraud.

Blum noted that the policy aligns with the agency's commitment to data transparency, but he added that there are valid concerns about protecting privacy and the integrity of the data.

"As CMS makes a determination about how and when to disclose any information on a physician's Medicare payment, we intend to consider the importance of protecting physicians' privacy and ensuring the accuracy of any data released as well as appropriate protections to limit potential misuse of the information. And as always, we are committed to protecting the privacy of Medicare beneficiaries," said Blum.

The AAFP recognizes the potential value of releasing Medicare payment data to ensure patients are receiving appropriate and high-quality care. If used correctly, these data can provide accurate and meaningful information to patients, physicians and other stakeholders that will help them improve quality at the point of care, said the AAFP and other groups that signed on to the September letter. But, the release of any such data must have safeguards that ensure the information is not misconstrued or misused and that provide the appropriate context for the information, such as demographics, comorbidities and the costs of providing care.