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Life Health > Health Insurance > Medicare Planning

Bill would make Medicare reimbursements public

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Congress is considering a bill that would provide data on how much doctors who treat Medicare patients receive in reimbursements from the program. The new bill, introduced by Senators Charles Grassley (R-IA) and Ron Wyden (D-OR), would publicly disclose how much physicians receive for treating seniors for certain set services. The senators hope public disclosure would dissuade doctors from committing Medicare fraud as well as help watchdog groups to spot it.

Grassley and Wyden have called their bill the Medicare Data Access for Transparency and Accountability Act. In proposing the new requirement on the Senate floor, Grassley said, “I believe transparency in the health care system leads to greater accountability,” and quoted Justice Louis Brandeis, who said, “Sunlight is the best disinfectant.”

The bill would create a free website to record Medicare reimbursements for all participating providers and suppliers, not just physicians. The proposed website would be searchable in a number of different ways, including by individual item or service. The bill follows on the heels of a Wall Street Journal investigation of certain physicians who have received in excess of $1 million per year for prescribing an unusually high number of expensive tests and treatments for seniors.

The American Medical Association, as might be expected, has come out against the proposed legislation, explaining that the government entities whose job it is to combat Medicare fraud already have access to the data that the website would provide. Furthermore, says the group, doctors are entitled to privacy in regards to billing and posting doctors’ national provider identifier number might expose them to identity theft.

This bill is not the first attempt to make doctors’ reimbursement data available to the public. In the late 1970s, the former Department of Health, Education and Welfare attempted to publish a list of Medicare-participating clinicians and the amounts they received from the program. However, the Florida Medical Association and the AMA joined forced to prevent publication of the list in 1979, when a federal judge issued an injunction against it.

For more articles on Medicare, see:

Are doctors really dropping Medicare patients?

Feds get tough on health care fraud


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