CMS NEWS
FOR IMMEDIATE RELEASE
January 29, 2016
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
New Proposal to Give Providers and
Employers Access to Information to Drive Quality and Patient Care Improvement
MACRA provides
expanded opportunity for the use of Medicare and private sector claims data to
drive higher quality, lower cost care
The Centers for Medicare &
Medicaid Services (CMS) today proposed rules that will expand access to analyses
and data that will help providers, employers, and others make more informed
decisions about care delivery. The new rules, as required by the Medicare
Access and CHIP Reauthorization Act (MACRA), will allow organizations approved
as qualified entities to confidentially share or sell analyses of Medicare and
private sector claims data to providers, employers, and other groups who can
use the data to support improved care. In addition, qualified entities will be
allowed to provide or sell claims data to providers. The rule also includes
strict privacy and security requirements for all entities receiving Medicare
analyses or data, as well as new annual reporting requirements.
This initiative is part of a broader effort by the Obama Administration to
create a health care system that delivers better care, spends dollars more
wisely, and results in healthier people.
“Increasing access to analyses and
data that include Medicare data will make it easier for stakeholders throughout
the healthcare system to make smarter and more informed healthcare decisions,”
said CMS Acting Administrator Andy Slavitt.
The qualified entity program was
authorized by Section 10332 of the Affordable Care Act and allows organizations
that meet certain qualifications to access to patient-protected Medicare data
to produce public reports. Qualified entities must combine the Medicare data
with other claims data (e.g., private payer data) to produce quality reports
that are representative of how providers and suppliers are performing across
multiple payers, for example Medicare, Medicaid, or various commercial payers.
Currently, 13 organizations have applied and received approval to be a
qualified entity. Of these organizations, two have completed public
reporting while the other 11 are preparing for public reporting.
Today’s rules seek to enhance the
current qualified entity program to allow innovative use of Medicare data for
non-public uses while ensuring the privacy and security of beneficiary
information. Comments are welcome on this set of proposed rules. You can
submit your comments until March 29, 2016 here: http://www.regulations.gov
The proposed rule is on display at
the Office of the Federal Register at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-01790.pdf
and on 02/02/2016 and available online at http://federalregister.gov/a/2016-01790
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