Earlier this year CMS announced that they now have information outlining Medicare data and its relation to how much physicians earn. This type of clarity has not always been available to the public. In the past, CMS could only release information including a physician’s name, address, and phone number. This was because of rules and regulations put in place by the court in 1979. However, in 2013, the court removed these restrictions and now CMS is able to release this information. This will give the public better understanding of how physicians function and how much physicians earn when they are Medicare approved.
Data including how much physicians earn:
This set of data will show what services that over 880,000 physicians are delivering to their patients. It also shows how much physicians earn for each service they provide. According to CMS, they sorted the data by “provider, type of service, code, and whether the service was provided in a facility or in an office setting.” It is going to include things like the number of services that occurred, the average amount for all of the charges submitted for the services, and the average Medicare payment.
Why did CMS release the data?
There are a few different reasons for why CMS released the data. One of the reasons that CMS gave was to help with the search for abuse of the Medicare system by physicians. There have been healthcare fraud cases found where physicians are abusing the Medicare system by delivering unnecessary services to patients to earn more money. This essentially means that how much physicians earn is based on what services they give to patients even if the patient did not need the service. Other than wanting to make this available to prevent healthcare fraud, CMS also wants to make sure the public has this information available to them.
Is Patient Information Secure?
While CMS released a large amount of data, it is still completely free of patient information. The focus on the release is how much physicians earn and for what services. CMS has removed or blocked out any information related to a patient and/or Medicare beneficiary.
CMS revealed this data in an effort to make sure our healthcare industry continues to “promote quality and value.” With this data, officials will be able to investigate how much physicians earn in relation to healthcare fraud and abuse. They believe this is important in the effort to improve our healthcare industry.
What are your thoughts?