Senators Propose More Bills to Publish Medicare Claims Data

Two more senators have proposed bills to publish Medicare claims data online, following the introduction of a joint transparency bill by Sens. Charles Grassley (R-Iowa) and Ron Wyden (D-Ore.) last month, according to an American Medical News report.

The new bills were introduced by Sens. Dick Durbin (D-Ill.) and John Cornyn (R-Texas) on April 14. Sen. Durbin's bill, the Medicare Spending Transparency Act of 2011, would publish summary-level claims data on individual physicians and other providers on an annual basic. Published information would include the amount paid, number of patients seen, total number of patient visits and the top 50 diagnosis and service procedure codes claimed.

Sen. Durbin's bill would allow qualified individuals and groups — defined as groups that show they have the technical ability to analyze data and a productive use for it — to have full access to Medicare's billing data. Qualified groups would also need expertise in medicine, statistics, healthcare billing and healthcare fraud detection, according to the report.

Sen. Cornyn's bill, the Consumer Information Enhancement Act of 2011, would make Medicare claims data available within six months of the legislation's passage. The data would be available starting with the 2005 billing year, and HHS would be required to contract with three consumer information organizations to store data and report on Medicare billing trends.

Physician organizations, including the American Medical Association, have opposed the publication of physician claims data, saying the publication violates physician privacy, leaves physicians open to identity theft and would not significantly improve fraud detection. Sen. Durbin counters that the legislation would help detect fraud and improve transparency by allowing non-governmental groups to access data.

Read the American Medical News report on Sens. Durbin and Cornyn.

Related Articles on Healthcare Fraud:
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10 Recent Stark, False Claims and Kickback Lawsuits Involving Hospitals and Health Systems

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