Tags: Healthcare Reform | Medicare | claims database | physician pay | public information | reimbursement | court ruling

Senators Want to Know What Medicare Pays Docs

Thursday, 03 Mar 2011 03:51 PM

Two Senate bills would publicize what Medicare pays physicians by repealing a 32-year-old court ruling that keeps those figures under wraps, the Wall Street Journal reports.

The congressional push to open up the Medicare claims database follows the Journal’s own investigative report on suspect Medicare reimbursements to doctors and other health practitioners.

The legislation would make Medicare fraud easier to detect without exposing patients' medical data, according to the bills’ sponsors, Republican Sen. Charles Grassley of Iowa and Democratic Sen. Ron Wyden of Oregon.

Any attempt to overturn the 1979 court ruling will be opposed by the American Medical Association, the powerful physicians’ trade group. An AMA spokesman said studies show that physicians are not a major source of Medicare fraud. He added, “Physicians, like all Americans, have the right to privacy regarding their personal financial information, and courts have repeatedly upheld this right.”

A Medicare fraud inspector who met with senators on Wednesday did not endorse the Grassley or Wyden bills, but said he would look into the “ramifications” of making the claims data public.


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