Should Raw Medicare Provider Data Stay Private?

Wednesday, May 7th 2008
Healthcare Policy • Health News • Healthcare Costs • Consumer Directed

The move towards cost transparency is generally something I support. But there is an argument I will buy that such should be prospective. That’s the line I’m buying with the current lawsuit over Medicare provider data that some consumer groups are waging.

In an unusual statement, the Health and Human Services Department endorsed the objectives of the consumer group that is suing, but said it wanted a higher court to clarify the lower-court rulings.

“We’re caught between court decisions,” said Christina Pearson, a spokeswoman for the department. “There’s conflicting information from different courts, so we’re pushing to get clarity.”

But the government’s legal brief in the case calls for the appeals court to reverse Sullivan’s ruling, leaving the restrictions on the release of data in place.

“I know the government was under a lot of pressure from the AMA in particular, arguing that the government should appeal,” Krughoff said. “Whether that’s the reason the government appealed, I don’t know.”

I’m torn, certainly. It is much easier to speak of the private insured having a ‘right’ to such data than Medicare patients considering what the two groups shoulder in terms of personal costs and responsibility for their health care access.

It is reasonable to imagine that a physician, somewhere out there, participates in Medicare under the understanding that his reimbursement data is shielded from public eyes based on previous court rulings, and would not participate otherwise. Under such a circumstance I think the opening of the Medicare database needs to be solely prospective and not retrospective. That means the data won’t be useful for years and years, I understand that but it is probably the right way to do it.

via WSJ Health Blog