By Christopher P. Young, Editor, G2 Compliance Advisor
In spite of objections from the American Medical Association (AMA), a Centers for Medicare and Medicaid Services (CMS) spokesperson told a Wall Street Journal (WSJ) reporter that it intends to publish annual updates to the payment data it published last April that detailed payments to about 880,000 individuals and organizations. The AMA says that the data was flawed and subjected some of its members to sensationalist news coverage.
The information had been kept secret through the efforts of the AMA since 1979 when it sought and obtained an injunction that prohibited Medicare from disclosing Medicare physician payment data, arguing that a physician’s right to privacy outweighs the public interest in how tax dollars are spent. The injunction was overturned in March, 2013 by a federal judge mainly through the efforts of the WSJ and its parent.
The information published in April 2014 covered payments to doctors, laboratories, ambulance companies and other providers under Medicare Part B during calendar year 2012 and totaled more than $77 billion, about one-seventh of the nearly $600 billion in annual Medicare expenditures.
The WSJ has taken advantage of the data release by publishing several stories based on details gleaned from the data, resulting in some Journal stories pointing out what appear to be cases of potential fraud and abuse in the Medicare program.
Other organizations, according to the WSJ articles, have found ways to use the data for their own purposes. Laboratory compliance officers can use the data in a variety of ways including benchmarking for their billing practices as a compliance monitor and as a means to detect data that might make their laboratory a potential target for government scrutiny.
CMS did not say when it would release the update but, it is likely to come this year, possibly in April and possibly including 2013 data. We will have to wait and see.