HHS must release Medicare claims data

Via Kaiser Daily Health Policy Report:

HHS last week inthe U.S. Court of Appeals for the District of Columbia filed an appealof an August 2007 court decision that requires the department torelease Medicare claims data on more than 40 million beneficiaries and700,000 physicians, the Los Angeles Times reports (Alonso-Zaldivar, Los Angeles Times, 4/19).

InAugust 2007, the U.S. District Court for the District of Columbia ruledthat HHS must release Medicare physician claims data for Illinois,Maryland, Virginia, Washington state and Washington, D.C. In the case, Consumers’ CHECKBOOK/Center for the Study of Servicesfiled a lawsuit to obtain access to the data. HHS argued that therelease of the data would violate the privacy of physicians. However,the court rejected that argument because Medicare claims account foronly a portion of the incomes of physicians. According to the court,the release of the data would “help the public make more informedMedicare decisions” and provide “more information of how governmentfunds are spent.”

Consumers’ CHECKBOOK plans to post the dataonline for public use. Researchers could analyze the data to determinethe number of times physicians perform certain procedures and tocompare the mortality rates among patients of certain physicians, andhealth insurers could use the data to improve their analyses ofphysician quality (Kaiser Daily Health Policy Report, 8/27/07).

Consumer groups, employers and health insurers support the decision, and physician groups oppose the decision.  The American Medical Association,which has petitioned to join the HHS appeal, maintains that the datacould be misleading because they do not take into account differencesin patients treated by different doctors, the Times reports.