CMS Proposes ACA Medicare Claims Data Sharing Rule
On June 8, 2011, CMS published a proposed rule that would implement an ACA requirement to make standardized extracts of Medicare Parts A, B, and D claims data available to “qualified entities.” These entities will combine this Medicare data with private sector claims data to generate public reports evaluating the performance of providers and suppliers. CMS would evaluate whether an organization is eligible to receive data based on their qualifications in three areas: organizational and governance capabilities (including the ability to accurately calculate quality, efficiency, effectiveness, and resource use measures from claims data); the addition of claims data from other sources; and data privacy and security practices. The qualified entity must agree to share the reports confidentially with providers and suppliers prior to their public release to provide an opportunity to make corrections. No individual beneficiary data would be shared under this program. CMS will accept comments on the proposed rule until August 8, 2011.
