The Consumers’ Checkbook group is to continue its efforts to seek Medicare billing records in order to grade doctors on quality, despite a reversal from a federal appeals court on Friday (1/30). The nonprofit group had previously won a lower court ruling in 2007 that directed the government to release the records under the federal Freedom of Information Act. The federal Health and Human Services department, joined by the American Medical Association, appealed. In a split decision issued late Friday, a three-judge panel of the federal appeals court for Washington, DC, handed the consumer group a defeat.
AHIP Hi-Wire writes that the case is being closely watched as an important battle in the effort to reshape the nation’s health care system. Consumer advocates, employers and insurers argue that access to Medicare claims filed by doctors’ offices could help independent groups monitor quality and ferret out waste. Patients would not be identified. But doctors are worried that such disclosures would violate their privacy, and that resulting ratings could portray some physician’s offices inaccurately.