Medicare Claims Available for Research

Final Rule Outlines Privacy Provisions
Medicare Claims Available for Research
A recently released final rule enables certain organizations to gain access to a database of claims data on millions of Medicare beneficiaries that could be used to develop ratings reports on physicians and hospitals.

Certain organizations, including certain employer and consumer groups that monitor healthcare quality, can now use the data to support research on identifying high-quality healthcare providers or creating online tools to help consumers make healthcare choices, according to the Centers for Medicare and Medicaid Services.

"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 noted in a statement.

The rule, mandated under healthcare reform, also spells out privacy and security requirements for those receiving the billing records. For example, an organization that applies to receive the data "must demonstrate its capabilities to establish, maintain and monitor a rigorous data privacy and security program," according to the rule. Participants must sign a data use agreement spelling out security measures.

About the Author

Howard Anderson

Howard Anderson

News Editor, ISMG

Anderson is news editor of Information Security Media Group and was founding editor of HealthcareInfoSecurity and DataBreachToday. He has more than 40 years of journalism experience, with a focus on healthcare information technology issues. Before launching HealthcareInfoSecurity, he served as founding editor of Health Data Management magazine, where he worked for 17 years, and he served in leadership roles at several other healthcare magazines and newspapers.

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