CMS Proposes Medicare Data Transparency Rules

Newly proposed rules from the Centers for Medicare & Medicaid Services (CMS) would allow Medicare and private sector claims data to be used to produce public reports that measure the performance of doctors, hospitals and other healthcare providers.

The new rules will allow organizations that meet certain qualifications access, for a fee, to patient-protected Medicare data from Parts A, B and D. These reports will combine private sector claims data with Medicare claims data to identify which hospitals and doctors provide the highest quality, cost-effective care.

To receive the Medicare claims data, qualified entities would need to have claims data from other sources. To prevent mistakes in reporting results, entities must share the reports confidentially with providers and suppliers prior to their public release—giving providers and suppliers a chance to review the reports and provide necessary corrections.

Publicly released reports would contain aggregated information only and during the application process. Qualified entities would need to demonstrate their capabilities to govern the access, use and security of Medicare claims data.

I Advance Senior Care

I Advance Senior Care is the industry-leading source for practical, in-depth, business-building, and resident care information for owners, executives, administrators, and directors of nursing at assisted living communities, skilled nursing facilities, post-acute facilities, and continuing care retirement communities. The I Advance Senior Care editorial team and industry experts provide market analysis, strategic direction, policy commentary, clinical best-practices, business management, and technology breakthroughs.

I Advance Senior Care is part of the Institute for the Advancement of Senior Care and published by Plain-English Health Care.