The Wall Street Journal (WSJ) reported that after 33 years, Judge Marcia Morales Howard vacated the injunction that kept Medicare information private. Information on individual doctors has for the past 33 years been considered an issue of the doctor’s privacy. But Judge Howard said that since the Privacy Act had been narrowed in its scope, the broad injunction was no longer necessary. The vacation of the injunction is just a step on the road towards getting Medicare information about doctors to become public.
The American Medical Association (AMA) may still decide to appeal the ruling. They have been a proponent of the injunction, which hides Medicare data on the premise of privacy, for the past three decades. As the injunction stands, news organizations must file Freedom of Information Act requests to access the information, and these requests, now and in the future, can be granted or denied on an individual basis by the Department of Health and Human Services, which is over Medicare. The Obama administration in the past has been favorable towards data transparency, including in the Affordable Care Act a provision which makes the Medicare claims database more accessible by the public, for certain community groups, but not for news organizations.
The information could be beneficial because it could hold the key to detailing fraud and abuse. Specific doctor information, which doesn’t include the name of the doctor, but does include a general overview of Medicare data, can be used to determine if fraud or abuse is occurring. Under the injunction, the data, hidden under the guise of privacy, could also hide countless cases of abuse and fraud. The WSJ was able to gain limited information from 2010, which did reveal numerous cases of fraud and abuse. While the AMA may be protecting doctors’ privacy, they’re also protecting some doctors’ crimes.