August 31, 2007 in Nation/World

Federal judge orders release of Medicare doctor records

Ricardo Alonso-Zaldivar Los Angeles Times
 

Types of data

The files could reveal facts that affect cost and quality of care, such as:

“How many times a year a surgeon performs a type of operation.

“Which doctors fail to order preventive tests that could catch disease early.

“Which ones order duplicative tests or unnecessary hospitalizations.

WASHINGTON – Whether it’s a hernia repair or heart bypass, doctors who perform a given operation more frequently get better results. The problem for patients has been determining who those physicians are before picking one.

Now a court ruling appears to open the way for consumer access to such information, potentially transforming the relationship between doctors and their patients.

Last week, a federal judge in Washington ruled in favor of a group that sued the Health and Human Services Department to allow disclosure of specific data about doctors from the Medicare claims database. U.S. District Judge Emmet G. Sullivan concluded “a significant public benefit” could be served by releasing the data and ordered the department to turn it over by Sept. 21.

With information on more than 40 million patients and 700,000 doctors, the Medicare database is far richer than any private insurer’s. While it would not have information on some doctors, such as pediatricians, who don’t treat Medicare patients, it is considered the mother lode for data on those who treat adults.

The database’s usefulness has been limited by a decades-old government policy that protects the privacy of doctors, who fear the information could be used to micromanage the practice of medicine.

“These data will make it possible to develop measures that will be very helpful to consumers,” said Robert Krughoff, president of Consumers’ Checkbook, the nonprofit group that sued for the information.

Consumers’ Checkbook, which compiles ratings of a wide range of service providers, sells its information to individual subscribers. But Krughoff said it intends to make the Medicare data available free of charge.

The Department of Health and Human Services has not decided whether to appeal the ruling.

In the lawsuit, Consumers’ Checkbook sought access to data on doctors in Washington, D.C., and four states: Illinois, Maryland, Virginia and Washington. But Krughoff said the group has filed a Freedom of Information Act request for the same information from the remaining states.


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