Back in 1979, a Florida court issued a gag order barring the Centers for Medicare & Medicaid Services (CMS) from revealing how much Medicare Part B was paying individual doctors.
The Wall Street Journal succeeded at getting the injunction overturned in 2011. You can now find the information on a CMS website. Many are heralding the data release as a leap forward.
See also: CMS may post more physician pay data
The data release has many shortcomings. It provides no information on treatments by doctors who are non-Medicare assignment doctors, patients who pay cash, or patients who have Medicaid. (Medicaid, of course, was greatly expanded by the Patient Protection and Affordable Care Act.)
The release also excludes patients in Medicare Advantage plans; patients who paid for their care with private insurance; and Medicare payments for inpatient hospital care, skilled rehabilitation services, durable medical equipment and prescription drugs. Finally, the data release excludes physicians who received Medicare Part B payments for fewer than 11 patients.
But, for advisors, there’s another problem: The information CMS has provided is not necessarily the kind of information that the average consumer who uses traditional Medicare coverage and Medicare supplement plans is looking for.
Transparency always seems like a good thing. There is certainly a need to know how the government spends taxpayer money. But consumers, typically, are looking for an easy way to get answers to questions such as whether a plan covers their doctors, hospitals or medications.