AMA: Let docs correct released claims data

The American Medical Association (AMA) reasserted its opposition to the Center for Medicare & Medicaid Services' release of raw Medicare claims data in a letter Thursday to CMS Administrator Marilyn Tavenner.

When CMS released the data, it ignored AMA warnings about likely problems and limitations associated with the release, wrote James L. Madara, M.D., executive vice president and chief executive officer of the AMA, in the letter.

For example, he said, physicians are not currently able to correct or clarify data in the Provider Enrollment Chain and Ownership System (PECOS) that relates to them. "We do not accept the argument that all errors in the database were put there by physicians," Madara wrote. "Nor do we agree that unintentional administrative errors by physicians justify the deliberate release of inaccurate information that misleads patients and reduces trust in their physician."

Furthermore, Madara said, CMS itself has faced problems with inaccurate information releases, such as the Physician Compare website, which it had to fully overhaul because of inaccuracies in its search functions and underlying data. This demonstrates how commonplace inaccuracies are when releasing information for the first time, he said in the letter.

Although CMS created a patient tool that requires site viewers to read up on the data's limitations, which the letter calls "a step in the right direction," there is still work to be done. For example, the letter calls on all versions of the data to display the limitations more prominently.

In addition, Madara wrote that CMS should inform users that "(1) neither Medicare nor most other payers base their payments on charges; (2) that the payments listed in this file are revenues, used to run a practice, not pure physician income; and (3) higher payments from Medicare typically represent higher expenses." 

The AMA is concerned, the letter stated, that CMS is not devoting enough attention to making sure its data is complete, accurate and timely. "Physicians can't make any improvements with the information CMS released last month," AMA President Ardis Dee Hoven said in a statement. "What we can do is continue to provide high-quality care to our patients while urging CMS to give us information that will help us improve the way we deliver care."

To learn more:
- read the letter (.pdf)
- read the statement