Lawmakers Call for Access to Medicare Claims Data

Margaret Dick Tocknell, for HealthLeaders Media , June 20, 2013

A Senate bill would make Medicare claims and payment data available to the public in a searchable database that would be free to use.

On the heels of a Senate Finance Committee hearing that explored a wide range of healthcare pricing and transparency issues, three committee members introduced on Tuesday a bill to make Medicare claims data available to the public.

The Medicare Data Access for Transparency and Accountability Act (Medicare DATA Act) would require the Department of Health and Human Services to issue regulations making Medicare claims and payment data available to the public in a searchable database that would be free to use.

The bill requires that each provider be identified by a "unique identifier that is available to the public...such as the National Provider Identifier." It also clarifies that Medicare payments to physicians and suppliers do not fall under a Freedom of Information exemption.

In introducing the bill in the Senate, Sen. Chuck Grassley (R-IA) noted that with only a few exceptions almost all federal spending is available on the Internet through "That means virtually every other government program... is more transparent than the Medicare program."

He also sees the effort as countering waste and fraud in the $549 billion Medicare program. "If doctors know that each claim they make will be publicly available, it might deter some wasteful practices and overbilling."

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2 comments on "Lawmakers Call for Access to Medicare Claims Data"

stefani daniels (6/21/2013 at 11:52 AM)
the history of over prescribing and excessive ordering is well known. Claim form information can be viewed as a surrogate measure of resource utilization and much better data than the 'pricing' data recently released. In the hospital setting, the volume of tests, consultants, procedures continues to escalate putting hospitals (which largely get paid a fixed rate) and patients at financial risk (depending upon their insurance). Excessive and non-contributory medical interventions are the last large pool of untapped expenses that can be reined in. The more exposure of physician practice behaviors, the better choices the public can make.

Mary Jo Tomlinson (6/20/2013 at 9:37 AM)
it's called a fee schedule, this information has been available for a long, long time. ...maybe we could try to FIX it..instead of finding ways to make this system more cumbersome..probably to late?




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