CMS sees through Part B payment transparency efforts ahead of Datapalooza

Medicare standardized payment amounts, which remove geographic differences in payment rates for individual services, are newly included in 2014 dataset reporting as part of CMS’ Medicare transparency efforts. CMS’ third annual data release of the Physician and Other Supplier Utilization and Payment public use data, in advance of this year’s Health Datapalooza conference in Washington, D.C., is for almost one million district health care providers, who collectively receive over $91 billion in Medicare payments. The data release, comprised of 2014 values, revealed increases in both the number of providers and Medicare payments as compared to 2013 (see Increasing transparency, hospital and physician utilization data issued, Health Law Daily, June 1, 2015).

The Physician and Other Supplier Utilization and Payment data contains summarized information on Part B services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. Information includes payment and submitted charges, or bills, for services and procedures provided by each physician or supplier and allows for comparisons by physician, specialty, location, types of medical services and procedures delivered, Medicare payment, and submitted charges.

In additional transparency efforts, researchers who access this data via Limited Data Sets (LDS) will be able to request updates to their LDS claims files on a quarterly basis. CMS stressed the release of timely, privacy-protected data is vital as Medicare is increasingly paying providers based on the quality, rather than the quantity, of care given to patients.