Medicare data and measuring provider performance
Posted on by John Toussaint
CMS data experts are working feverishly to comply with Section 10332 of the affordable care act. This requires that by 2012 "Qualified Entities" will be able to access the medicare data. But this has never been done before so new regulations are being written regarding HIPPA compliance, Data use agreements, Business Associate Agreements which allow entities to exchange personal health information, and other important issues. The Center has been working with CMS administrators on these issues and others and they have been listening. In the last six years The Wisconsin Health Information Organization(WHIO) has solved many of the problems CMS is now struggling with. The good news is these officials are engaged and very interested in what we have learned which may allow them to write the regulations in a way that WHIO can receive this data and integrate it with the rest of the nearly 4.2 million residents that already exist in the data base. The following is a summary of what CMS is working to do in section 10332.
Section 10332 of the Affordable Care Act
- Requires that the Secretary make data available to qualified entities for the evaluation of performance of providers of services and suppliers
- Data includes the standardized extracts (as determined by the Secretary) of claims data under Parts A, B and D for items and services for one or more geographic areas and time periods as requested by the qualified entity
- The Secretary is required to take the necessary actions to protect the identify of beneficiaries
- Data is made available to the qualified entity at a fee equal to the cost of making the data available
- Uses and Methodologies.
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