CMS Will Reveal Doctor Medicare Pay On an Individual Basis Under New Policy

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By Mindy Yochelson  

Jan. 14 --The Centers for Medicare & Medicaid Services said Jan. 14 that it has instituted a new policy for releasing data on amounts of Medicare payments to doctors under the Freedom of Information Act that will rely on an individual approach to requests.

“CMS will make case-by-case determinations as to whether exemption 6 of the Freedom of Information Act applies to a given request for such information,” according to a notice to be published in the Jan. 17 Federal Register.

Exemption 6 requires the CMS to weigh the privacy interest of individual physicians and the public interest in disclosing such information.

This is “a step forward in making Medicare data more transparent and accessible, while maintaining the privacy of beneficiaries,” CMS Principal Deputy Administrator Jonathan Blum said in a blog posting Jan. 14.

“As CMS makes a determination about how and when to disclose any information on a physician's Medicare payment,” Blum said, the agency will “consider the importance of protecting physicians' privacy and ensuring the accuracy of any data released as well as appropriate protections to limit potential misuse of the information.”

Competing Interests

Previously, the Department of Health and Human Services, the CMS's parent agency, considered the competing interests of public transparency and privacy, according to the notice, “Modified Policy on Freedom of Information Act Disclosure of Amounts Paid to Individual Physicians under the Medicare Program.”

However, for disclosure of amounts paid to individual physicians by Medicare, the public's interest was considered insufficient to compel disclosure under FOIA, it said.

A ruling in May 2013 by the U.S. District Court for the Middle District of Florida lifted a 1979 injunction, based on the Privacy Act of 1974, that had prohibited the HHS from releasing Medicare physician reimbursement data that would identify specific physicians .

After that, in August 2013, the agency sought public comment on the most appropriate path regarding the release of data, with comments due Sept. 5 (152 HCDR, 8/7/13).

AARP Position

In one of the comments, AARP said that “transparency through public release of all relevant data, including physician data, is essential for a vibrant, effective, and competitive marketplace in Medicare.”

The group said that “the program itself, the people it serves, and the public at-large, have a vested interest in understanding how Medicare dollars are used by physicians and other health care providers.”

According to the agency notice, which will take effect 60 days after publication, “the outcome of the balancing test will depend on the circumstances.”

In his blog, Blum also said that the CMS will generate and make available “aggregate data sets” regarding Medicare physician services for public consumption.


To contact the reporter on this story: Mindy Yochelson in Washington at

To contact the editor responsible for this story: Ward Pimley at

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