Keeping you updated on the latest Medicare and Part D news

CMS Releases 2012 Medicare Part B Payments Data

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In a huge step towards transparency, CMS released data covering $77 billion in Medicare Part B payments in 2012. The information includes over 880,000 distinct health care providers and 6,000 different types of services and procedures, allowing for comparisons by physician, specialty, service/procedure, Medicare payment, and submitted charges. Only procedures that providers performed on more than 10 Medicare patients were included in the data, leaving out over $22 billion of Medicare spending on physician and provider services. This effort by CMS was made possible in 2013, when a federal judge vacated the 1979 injunction won by the American Medical Association (AMA), which prohibited the release of physician-specific Medicare data on the grounds of physician privacy.

Press Release

Multiple news sources have focused on doctors who received millions in Medicare payments. The AMA has expressed concerns that the raw payments data without proper context could mislead the public. For example, doctors who treat exclusively Medicare patients, treat sicker patients, or perform expensive treatments, are likely to receive more in payments. And in some cases, multiple professionals are allowed to bill under the Medicare number of a single physician. 

Nevertheless, the new data enables consumers the unprecedented ability to research and compare physicians, and helps watchdog organizations research fraud, The Wall Street Journal has launched a tool where users can search through the data by provider, name, specialty, and location.


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