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Authors: D. Mark Wilson
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This week, the Senate passed and President Obama signed an HR Policy-supported bill to repeal Medicare's troubled physician payment formula and improve the program's health care transparency initiatives by expanding employer access to Medicare claims data. Specifically, the Medicare Access and CHIP Reauthorization Act of 2015 will allow organizations that are qualified under the ACA to receive Medicare claims data to analyze and redistribute it to employers for the purpose of providing health care benefits to employees and retirees. The Qualified Entity (QE) program was created by the ACA to allow organizations to access and analyze Medicare claims data for purposes of evaluating the quality, efficiency, and effectiveness of providers. However, in its previous form, the QE program restricted what organizations were allowed to do with the data. The new law relaxes some of those restrictions, and requires HHS to make utilization and payment data for physicians and professionals under Medicare publicly available.
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