Sens. Tammy Baldwin (D-Wis.) and John Thune (R-S.D.) have reintroduced their bill that would provide greater transparency to Medicare claims data so that the qualified entities who have access to that data can share it with payers, providers and research institutions.
Bill S.1758, first introduced in November 2013, builds on the work of the Center for Medicare & Medicaid Services' (CMS) Qualified Entity (QE) Program, which lets organizations apply to receive standardized extracts of Medicare claims data and use the data to evaluate provider and supplier performance.
"However, current law is far too restrictive on which organizations can participate in the QE program, what QEs can do with the Medicare data once they have received it and the degree to which QEs can support their own data maintenance infrastructures," according to a summary of the bill.
The summary further described how the bill would address the QE Program's two key roadblocks to sharing Medicare claims data.
- It would rewrite the QE program rules so entities that receive and analyze the information can distribute it to "authorized subscribers," such as the aforementioned payers, providers and research institutions, so those organizations can make more informed decisions.
- It would let qualified entities charge a "voluntary fee" to those subscribers in order to fund further research and analysis.
CMS publicly released Medicare claims data for the first time in 2014, but that data is insufficient for analyzing care quality, the bill summary said.
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