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New Rule Brings Sweeping Changes to Physician Privacy

On January 17, the U.S. Department of Health and Human Services (HHS) announced that the Centers for Medicare & Medicaid Services (CMS) would begin granting Freedom of Information Act (FOIA) requests for Medicare reimbursement to individual physicians on a “case-by-case basis.”  The new policy, effective March 18, 2014, is a departure from CMS’ long-standing practice of withholding information on physician reimbursement under the Medicare program.

Since 1980, HHS has maintained that public interest in disclosure of the amounts paid to individual physicians under Medicare is not sufficient to outweigh the privacy concerns of individual physicians.  In May 2013, U.S. District Judge Marcia Morales Howard dissolved a 1979 federal injunction that barred the release of Medicare physician payment data.  That ruling prompted HHS to revisit its policy and reverse it in favor of increased data-transparency.  Reimbursement information under other federal health care programs is not covered by the new policy.

In March, CMS will begin evaluating requests for information on Medicare reimbursement of individual physicians using a “balancing test” to determine whether disclosure is appropriate.  HHS says that the balancing test will be applied to weigh the public’s interest in disclosure of the information against the individual physician’s personal privacy concerns.  In addition to responding to FOIA requests, CMS will make available aggregate data sets regarding Medicare physician services for public consumption.

This watershed ruling by HHS means that physicians need to take immediate action. Visit the blog again on Thursday when I’ll discuss what needs to be done now. 

This article is intended as a summary of federal or state law and does not constitute legal advice.

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