Public Payor News

CMS Allows Use of Medicare Data to Rate Physicians, Hospitals

The Centers for Medicare and Medicaid Services (CMS) approved changes this week to the final rule that will allow qualified organizations access to Medicare data to produce public performance reports on physicians, hospitals and other healthcare providers. The changes are based on recommendations that were submitted after the final rule was initially published in June, as authorized by the Patient Protection and Affordable Care Act.

Included in the changes is the extension of the confidential review time Medicare providers have to appeal performance reports before they are made public. The final rule contains privacy and security requirements and penalties that are designed to protect patients, physicians and other Medicare providers. Medicare has indicated that the first performance reports will be available to the public in late 2012. CMS says the reports will help patients identify physicians and hospitals that provide the highest quality, most-cost effective care.

Also included is a lower fee that qualified organizations must pay to access patient-protected Medicare claims data to produce public reports that rate physicians, hospitals and other Medicare providers. Those reports also are expected to include private-sector claims data.

CMS Offers Tool to Help Physicians and Other Eligible Physicians (EPs) with EHR

CMS has made available an online, interactive resource called, An Introduction to the Medicare EHR Incentive Program for Eligible Professionals (PDF). It covers program basics, eligibility and registration and includes a description of the State 1 meaningful-use criteria, with advice on choosing optional measures for the attestation phase of the program.

See related story, Meaningful Use Stage 2 Delayed Until 2014 (Bulletin, December 2, 2011)

EHR Incentive Program Payment and Registration Data Available on CMS Webpage

CMS’s new web page is where you can find up-to-date information about the EHR Incentive Program. Included are program payment and registration data and other updates.  

Additionally, updates and more resources are available at the NCMS Medicare Resource Center at:


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