Doctors’ Medicare billing records, sought to assess care quality, not public

by • March 1, 2009 • UncategorizedComments Off on Doctors’ Medicare billing records, sought to assess care quality, not public1306

© 2009 The Medical-Legal News

• The Gist: What’s public and what’s not is a perennial debate. Should doctors who receive Medicare money have to disclose —via patient records — how they are managing care with those public funds?
— RC

A consumer group that sought Medicare billing records under the Freedom of Information Act in order to double-check doctors and compile quality data on them was handed a defeat in late January, according to the Associated Press. Patient names would not have been disclosed.
The AP story said that the case is “considered an important battle in the effort to reshape the nation’s healthcare system.”
Doctors argue that disclosure of such data is a violation of privacy and that raw billing records are not necessarily a reflection of quality, as some doctors deal with harder-to-treat, or outlier, patients. The AMA and the federal Health and Human Services department are opposed to such disclosure.
Consumer groups, employers and insurers maintain that disclosure of Medicare claims filed by doctors’ offices will identify quality and ferret out waste.
According to the AP, the Consumers’ Checkbook group won a lower court ruling in 2007 in the matter, but lost at the hands of the three-judge appeals panel.
The group vows to fight on. 

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