Ryan Introduces Medicare Data Bill to Improve Health Care Quality, Inform Public, Lower Costs
First District Congressman Paul Ryan today introduced the Medicare Quality Enhancement Act with Congressman Artur Davis (D-AL) to provide certain qualified private-sector organizations access to Medicare data so they can analyze the information and issue reports on the quality, cost, efficiency and effectiveness of our health care system. These reports will help inform the public so individuals can make better decisions about their medical care. Additionally, this information will aid health care providers, policymakers, patient advocacy groups and others with improving the quality and lowering the cost of health care - all while maintaining patient privacy. In the U.S. Senate, this legislation has been introduced by Senators Judd Gregg (R-NH) and Hillary Clinton (D-NY).
"In order for patients and their families to make the best decisions about their medical care, they need reliable information on the cost and quality of care that doctors and hospitals provide. This bill will help by making better use of the vast amount of health care data the federal government holds through Medicare. If researchers are able to analyze this information and release their findings to outside groups and the public, this will help pinpoint problems, improve quality, and drive down costs," Ryan said.
This bipartisan legislation authorizes the secure disclosure of Medicare data to qualified organizations, known as Medicare Quality Reporting Organizations (MQROs) with whom the government enters into a contract. These organizations will analyze the data and develop reports, while observing necessary safeguards to protect patient privacy. MQROs must have the information technology infrastructure to securely store the entire Medicare claims database and have research expertise to develop reports on health care quality and efficiency.
Private-sector organizations can submit a request to an MQRO for a report based on Medicare data and private data that is publicly available or is provided by the entity making the request for the report. MQROs may charge the group making the request a reasonable fee for the development and release of the report. The report must be made available to the public through the website of the Centers for Medicare and Medicaid Services and other appropriate means no later than one year after the date that the report is released to the entity who requested it.
The Medicare Quality Enhancement Act requires the protection of Medicare beneficiary privacy under both the Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act, and it requires a privacy review by the U.S. Department of Health and Human Services of each analytical report prior to release.