The CMS (Centers for Medicare and Medicaid Services) has proposed new principles it hopes will expand approach to analysis and information that assist employers and contributors make more informed decisions about the care delivery.
As needed by the Medicare Access and CHIP Reauthorization Act, the recent rules are anticipated to permit organizations — those passed as qualified entities — to confidentially share or sell analyses of Medicare and private sector claims information to contributors, employers, and anyone else who can utilize that data to enhance care. Those qualified organizations will also be permitted to offer or sell claims information to contributors.
The rule also proposes strict privacy and security needs for any entity getting Medicare analysis or data. In addition, there will be latest new annual reporting requirements.
“Increasing approach to analyses and information that involve Medicare data will make it simpler for stakeholders throughout the healthcare network to make smarter and more informed healthcare decisions,” stated CMS Acting Administrator Andy Slavitt.
The qualified entity program, authorized by the Affordable Care Act, permits qualified organizations approach to patient-protected Medicare data to generate public reports. Such entities must unite the Medicare data with other claims information, like private payer data; this enables them to generate quality reports representative of how contributors and suppliers are performing across various payers.
To date, thirteen organizations have applied for, and got, approval to be a qualified entity. Of these, 2 have completed the public reporting. The other eleven are making preparation for that.
The latest rules, claimed CMS, targets to bolster the present qualified entity program, permitting for more creative uses of Medicare data for non-public uses, while at the similar time ensuring the privacy and protection of beneficiary data.
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