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HHS Appeals Ruling That Would Give Consumers More Access to Physician Medicare Claims Database

According to an article in today’s Los Angeles Times, the Department of Health and Human Services and the Department of Justice have appealed a ruling from the U.S. District Court for the District of Columbia that would give consumers more access to Medicare healthcare data.

Specifically, the August 2007 ruling, based on a FOIA request and then a subsequent lawsuit by the advocacy group Consumers’ Checkbook/Center for the Study of Services, would have allowed disclosure of a subset of Medicare billing records for four states (Illinois, Maryland, Virginia, and Washington) and the District of Columbia. The information requested would not have contained any patient identifying information, but could have potentially allowed consumers to get more understanding of the operations of Medicare and the Center for Medicare and Medicaid Services (CMS), as well as make decisions about physician expertise and efficiency, according to the Times. As the judge’s decision put it, “The public interest at stake is the interest in obtaining information that would help the public make more informed Medicare decisions and the interest in more information of how government funds are spent.”

However, the American Medical Association opposed the ruling, and has also petitioned to join the appeal. The HHS appeal is based on a 1979 federal court ruling that blocked release of Medicare physician reimbursement data. HHS states that it shares the goals of Consumers’ Checkbook in providing a transparent health care marketplace for consumers, but says that the 1979 ruling conflicts with the 2007 ruling. Observers quoted in the Times article said that the HHS was under pressure from the AMA to keep the data from being released and that it wasn’t just a matter of conflicting legal opinions.

The HHS news release announcing its decision to join the DOJ appeal against release of Medicare data is here.

Last summer’s ruling on the release of the data is here.