Medicare Data Rules Finalized

in Affordable Care Act, Health Benefits

On Monday, the Centers for Medicare and Medicaid Services (CMS) issued final regulations making claims data from Medicare available to “qualified entities.”  The rule gives qualified entities, like employers, insurers, consumer groups and their contractors, access to data that can help them identify high quality health care providers or create online tools to help consumers make educated health care choices.  Information that could identify specific patients, however, will not be publicly released and strong penalties will be in place for any misuse of data.

 CMS hopes that the final regulations will make health care information more available and allow consumers to make more informed choices about their care. 

 Eligible entities can start the qualification process to exchange data with Medicare after the final regulations become effective in early January.  The final regulations become effective 30 days after publication in the Federal Register, which is expected on December 7th.

Link to the final rules is here:  http://www.gpo.gov/fdsys/pkg/FR-2011-12-07/pdf/2011-31232.pdf