Medicare Data Becoming Available for Preparing Doctor Report Cards | Shapiro, Washburn & Sharp

Choosing a doctor or surgeon can be a crapshoot. Patients often have little or no information on physicians’ experience or history of successful treatments, medical mistakes or malpractice claims. This puts people needing health care services ranging from long-term care for chronic conditions like diabetes to back surgery at risk for suffering life-threatening and debilitating complications from prescribing errors, misdiagnoses, medical negligence and surgical errors.

A small step toward making patients better informed about the doctors and surgeons to whom they entrust their health and lives was taken earlier in 2011 when federal officials eased restrictions on the public’s access to the National Practitioner Data Bank, which records malpractice actions. Now, a change in federal laws and regulations will give patients much more complete information on doctors that was previously tightly held by Medicare.

On December 5, 2011, acting under a requirement of the Affordable Health Care Act, the Centers for Medicaid & Medicare Services announced the publication of a final rule that permits employers and consumer groups to comb the Medicare provider database for information on the number of times a doctor or surgeon has performed a procedure and how often those physicians’ patients have experienced preventable errors. No patient information will be released, and the agency has called for stiff penalties for any group that misuses the Medicare data or handles records in ways that allow individual patients to be identified.

As noted in an Associated Press report, the Medicare database includes billing records for “47 million beneficiaries and nearly every doctor and hospital in the country.” CMS Acting Administrator Marilyn Tavenner was not exaggerating, then, when she told the press. “This is a giant step forward in making our health care system more transparent and promoting increased competition, accountability, quality and lower costs.”

Information on doctors is essential for patients looking to protect themselves from the harms caused by medical malpractice. The organizatins given access to the Medicare database are expected to begin producing doctor report cards by late 2012. The goal is to provide patients easily understandable grades they can review when they have to choose a doctor or surgeon.

Having represented many victims of medical mistakes and surgical errors, I applaud CMS for sharing its information. I also look forward to the time when patients no longer must select health care providers blindly.

EJL