Senators Push for Public Access to Medicare Claims Database

During a Senate Finance Committee hearing on Wednesday, Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) pushed for legislation that would overturn a 1979 court injunction blocking public access to data on the amount that individual physicians receive in Medicare reimbursements, the Wall Street Journal reports.


The court injunction stems from a lawsuit that the American Medical Association and the Florida Medical Association filed to prevent former President Jimmy Carter's administration from publishing a list of annual Medicare reimbursements.

The injunction, which has remained in effect since the 1979 ruling, bars the government from providing public access to a federal database of Medicare claims. The database is considered a crucial tool for rooting out Medicare fraud, according to the Journal.

The issue came under more scrutiny in January, when Dow Jones -- publisher of the Journal -- filed a lawsuit seeking public access to the Medicare claims database.  

Legislation Details

Grassley said his proposed legislation would open the Medicare database to the public as part of an effort "to make government transparent, because with transparency there comes accountability." He added that the database also would aid in fraud-fighting initiatives (Tamman/Schoofs, Wall Street Journal, 3/3).

Wyden said public access to the database "could create a very substantial disincentive for some of these multi-million dollar rip-offs" (Pecquet, "Healthwatch," The Hill, 3/2).

Both Grassley and Wyden said they are not seeking the release of patient-specific data, adding that they support patient privacy protections.

Federal Officials, AMA Respond

During the Finance Committee hearing, HHS and CMS officials declined to offer their support for providing public access to the Medicare claims database.

Peter Budetti, who oversees CMS' antifraud efforts, said, "The concept (of making the database public) has a lot of ramifications." Budetti said he would report back on the issue (Wall Street Journal, 3/3).

The American Medical Association opposes the opening of the Medicare database, saying it would violate physicians' privacy and compel some doctors to leave Medicare.

AMA President Cecil Wilson said that "studies have demonstrated that physicians are not a significant source of Medicare fraud" ("Healthwatch," The Hill, 3/2).

Barbara Duck
This is the opinion of those who don't the mechanics of doing something like this in a format the public could use, it's a lot of work and there's many errors. Again what is expected from those with limited digital knowledge and as a case study why the did the NY Times sell their doctor referral system a few days ago, same flawed data that is out there on other sites, perhaps all using the same data base? I mention this as it is a real good indicator as to what the use of the Medicare data base would lead to for consumers and it would accomplish little other than to confuse and muddy the waters further. Now law enforcement and the office of the inspector general of course should have all access to verify, run audits and catch fraud, but the public, what are you going to accomplish, more flawed data like the MD ratings and referral sites with dead doctors listed and tons of errors? Something to think about.

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