Physician Payments Could be Revealed Under Bipartisan Bill

Senators Ron Wyden (D-Ore) and Chuck Grassley (R-Iowa) plan to cosponsor legislation requiring the Department of Health & Human Services to publicize information on Medicare payments made to  physicians. 

This information has been off limits to the public since the 1970's, when the Florida Medical Association and the American Medical Association sued to keep it secret.  The issue has resurfaced in recent months after the Wall Street Journal and the Center for Public Integrity sued the Department of Health & Human Services to obtain information on payments made to doctors and other individual providers in the Medicare claims database.  After their lawsuit, the Wall Street Journal and the Center for Public Integrity agreed to receive a pared-down version of the database, and were forbidden from identifying the 5% of providers on whom they received data. 

Even with those restrictions, both organizations were quickly able to identify patterns of likely fraud and the idea of opening the database has been gaining traction across party lines as Medicare and Medicaid fraud - estimated at $70 billion to $120 billion a year - becomes an even bigger worry. 

The AMA argues that opening up the database would be a violation of doctors' privacy and could lead to some of them leaving the program.  While pointing out they have zero tolerance for fraud, the AMA believes Medicare claims are already subject to scrutiny by organizations specifically designed to aggressively ferret out improper claims.