<nobr>Apr 18, 2008</nobr>

HHS Appeals Decision Regarding Release of Medicare Physician Claims Data

The Department of Health and Human Services (HHS) on April 16 appealed a district court ruling from August 2007 in which a consumer research and information organization won a court battle over its Freedom of Information Act (FOIA) lawsuit that would require HHS to release data on every physician claim paid by Medicare.

In Consumers' CHECKBOOK, Center for the Study of Services v. U.S. Department of Health and Human Services, the U.S. District Court for the District of Columbia ruled against privacy concerns raised by the federal government, finding that a FOIA privacy exemption did not apply and that there is an overriding public interest in how government funds are spent and helping consumers make better Medicare decisions.

HHS said it is appealing the decision because of two conflicting court opinions that control HHS's release of data. According to HHS, in 1979 a federal court in Florida issued a ruling that prohibits Medicare from releasing physician reimbursement data in a manner that would enable the user of that data to identify individual physicians, stating that the information is protected by the Privacy Act of 1974. HHS says that it supports the goals of providing quality performance and cost information to consumers, but that the data sought by Consumers' CHECKBOOK, when combined with other publicly-available data on Medicare fees, could lead to the disclosure of annual Medicare reimbursement amounts for individual physicians, resulting in a violation of the existing Florida court order. HHS argues in its appeal that the recent decision is based on an erroneous application of the Florida court order and of the FOIA exemption that protects privacy.

ERIC applauded the earlier district court ruling, believing that increased disclosure will help improve the quality of care, while lowering overall health care costs.

If you have questions or comments on this issue, contact either Edwina Rogers, erogers@eric.org, or Rohan Beesla, rbeesla@eric.org.


Websites:

HHS Announcement

Consumers' CHECKBOOK Release

Consumers' CHECKBOOK Ruling

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