Today, Senator Wyden and I reintroduced the Medicare Data Access for Transparency and Accountability Act. This collaborative effort includes two ideas for making Medicare billing and spending more transparent.
The first provision comes from a bill I introduced in 2011 to enhance the government’s ability to combat Medicare and Medicaid fraud. It would require the Secretary of Health and Human Services to issue regulations to make Medicare claims and payment data available to the public, similar to other federal spending disclosed on www.USAspending.gov.
That website was created by legislation sponsored by then-Senator Obama and Senator Coburn. It lists almost all federal spending, but it doesn’t include payments made to Medicare providers.
That means virtually every other government program, including some defense spending, is more transparent than the Medicare program.
Omitting Medicare spending is especially alarming when you consider the portion of federal spending that goes through the Medicare program. In 2011, the federal government spent $549 billion on Medicare.
Taxpayers have a right to see how their hard-earned dollars are being spent. There should not be a special exemption for hard-earned dollars that happen to be spent through Medicare.
Transparency will restore that taxpayers’ right.
Also, if doctors know that each claim they make will be publicly available, it might deter some wasteful practices and overbilling.
Our bill accomplishes this by requiring the Secretary of Health and Human Services to make available a searchable Medicare payment database that the public can access at no cost.
The second provision in our bill clarifies that data on Medicare payments to physicians and suppliers do not fall under a Freedom of Information Act (FOIA) exemption.
In 1979, A U.S. District Court ruled that Medicare is prohibited from releasing physicians’ billing information to the public.
For over three decades, third parties that tried to obtain physician specific data through the FOIA process have failed. Taxpayers have been denied their right.
Another recent court decision lifted the injunction, but it does not go far enough.
Our bill would make clear the intent of Congress and give additional tools for the public to finally gain access to important Medicare data.
I would like to provide one example of how valuable access to Medicare billing data can be.
In 2011, using only a small portion of Medicare claims data, the Wall Street Journal was able to identify suspicious billing patterns and potential abuses of the Medicare program.
The Wall Street Journal found cases where Medicare paid millions to a physician sometimes for several years, before those questionable payments stopped.
That was only one organization using a limited set of Medicare data. When it comes to public programs like Medicare, the federal government needs all the help it can get to identify and combat fraud, waste and abuse, and that is why a searchable Medicare claims database should be made available to the public.
I’ve often quoted Justice Brandeis, who said, “Sunlight is the best disinfectant.” That is what Senator Wyden and I are aiming to accomplish with the Medicare Data Act.
I yield the floor.