Last year’s Patient Protection and Affordable Care Act (Obamacare) promised to allow outside groups use of Medicare billing records as a way to analyze and publicly report on the quality of care.
But now proposed rules that would guide the release of the data are being criticized by consumer groups that say the rules would make independent accountability impossible.
The rules being developed by the Centers for Medicare & Medicaid Services (CMS) propose restricting the release of Medicare billing data to “qualified entities.”
These "qualified entities" would have to pay up to $200,000 for the data, have their methods pre-approved by the government, limit public reporting to topics approved by the health care industry aa well as present reports and findings to every doctor and facility being studied; which would likely result in censorship.
Lisa McGiffert, director of the 'Safe Patient Project,' run by Consumers Union, says that the proposed rules would make it impossible for Consumers Union to use the data: “The best-kept secret in America is what doctors are doing. People should be able to find out information about outcomes of care, whether their docs are using appropriate practices and whether they’re providing too much of something that people don’t need.”
Bruce Boissonnault, president and CEO of the Niagara Health Quality Coalition, said: “We will only see the scraps of information that the industry wants us to discuss. It’s advertising wrapped in a lab coat."
However, the American Medical Association actually wants more restrictive rules. The proposed rules say doctors would need 30 days to review any analysis before it’s publicly reported, but the AMA wants that review period to be 90 days.
The AMA also wants Medicare to consider complaints by physicians against an organization before allowing the organization access to the data. The Federation of American Hospitals, which represents investor-owned health care facilities, wants a limit on the number of qualified entities that have access to the data.