April 23: The Centers for Medicare & Medicaid Services (CMS) just released a new interactive search tool for people to navigate CMS's Medicare database. Last week we noted that many news outlets—including the New York Times and Washington Post—had searchable databases hours after CMS released the Medicare data on April 9th. To be fair, CMS has more on the line with regards to the accuracy of its own system. The original data consisted of thirteen separate excel databases with thousands of entries.
According to an announcement on CMS' blog, "[u]sers can search for a provider by name, address, or National Provider Identifier (NPI). Once a user selects a provider, the tool returns information about the services the provider furnished to Medicare beneficiaries, including the number of services provided, the number of beneficiaries treated, and the average payment and charges for such services."
"As with the data set, the look-up tool does not include information for cases where a provider administered a particular service 10 or fewer times to ensure the confidentiality of patients' personal information," CMS states.
"In addition, the information in the look-up tool only reflects the services provided to Medicare fee-for-service beneficiaries and does not include measurements of the quality of care provided by a provider." However, we argued in our last article that some reporters have not quite taken this warning to heart.
CMS also noted: "Within the first week of posting the data, more than 150,000 users downloaded the data, and the CMS website where the data is posted had nearly 250,000 page views." Millions of others were exposed to news stories on the Medicare release data as every major publication ran an article about high paid doctors.
Reuters recently published an article on how qui tam, or whistleblower, attorneys are reportedly mining the Medicare data for signs of fraud. While the Wall Street Journal's search tool might have been a suspect database upon which to base a lawsuit, the CMS's program perhaps offers some legitimacy to the data mining process.