Medicare Claims Are Public, Judge Rules

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Records of claims physicians file with the federal Medicare program are public and must be disclosed to a consumer publication seeking them under the Freedom of Information Act, a federal judge in Washington ruled yesterday.

The Justice Department opposed releasing the data, arguing that disclosure could invade doctors’ privacy by making public their income. However, Judge Emmet Sullivan said those concerns were “minimal” and outweighed by the public’s interest in the subject.

“The information plaintiff requests to be disclosed concerns only the business income of the physicians involved and not intimate facts about their personal lives,” he wrote. The judge noted that Medicare represents just a portion of most doctors’ income. He compared the situation to that of farm subsidy payments, which courts also have ruled to be matters of public record.

The outlet that brought the suit, Consumers’ Checkbook, said it planned to use the data to study payments to doctors inexperienced at performing specific “difficult” procedures. The group also said it wanted to examine how much Medicare pays to physicians with disciplinary records or poor ratings from reviewers.

The consumer publication agreed from the outset not to seek the names of patients whose visits led to the Medicare claims.

Judge Sullivan also rejected Medicare’s position that Consumers’ Checkbook should pay nearly $20,000 to cover the costs of compiling the data for four states and the nation’s capital. Federal officials said the group’s interest in the data was primarily commercial because it charges for some reports and for access to part of its Web site, but the judge said the fact that the nonprofit organization charges some fees did not undercut the “significant public benefit” of releasing the data.

A spokeswoman for the U.S. attorney’s office in Washington said the decision was being reviewed by government lawyers and other officials.


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