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Category Archives: Medicine

Medicare Provider Utilization and Payment Data: Physician and Other Supplier

“As part of the Obama Administration’s efforts to make our healthcare system more transparent, affordable, and accountable, the Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (Physician and Other Supplier PUF), with information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals.  The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS’s National Claims History Standard Analytic Files. The data in the Physician and Other Supplier PUF covers calendar year 2012 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population. While the Physician and Other Supplier PUF has a wealth of information on payment and utilization for Medicare Part B services, the dataset has a number of limitations.  Of particular importance is the fact that the data may not be representative of a physician’s entire practice as it only includes information on Medicare fee-for-service beneficiaries.  In addition, the data are not intended to indicate the quality of care provided and are not risk-adjusted to account for differences in underlying severity of disease of patient populations.  For additional limitations, please review the methodology document available below. Data are available in two formats:

  • Tab delimited file format (requires importing into database or statistical software; SAS® read-in language is included in the download ZIP package)
  • Microsoft Excel format (.xlsx), split by provider last name (note: organizational providers with name starting with a numeric are available in the “YZ” file).

CMS has also created two summary tables: 1) aggregated information by physician or other supplier and 2) aggregated information by State and HCPCS code.   A detailed methodology document can be found in the Downloads section below which contains important information regarding the limitations of data usage.”

CFPB Spotlights Concerns with Medical Debt Collection and Reporting

“…the Consumer Financial Protection Bureau (CFPB) released a report that found medical debt has a significant impact on consumer credit, as 43 million Americans have overdue medical debt on their credit reports. The CFPB is concerned that the systems for incurring, collecting, and reporting medical debt can create difficult challenges for consumers. To better addressContinue Reading

Patients Prescribed Narcotic Painkillers Use More of Them for Longer, Study Finds

New York Times: “While a major public health campaign has had some success in reducing the number of people who take potentially addictive narcotic painkillers, those patients who are prescribed the drugs are getting more of them for a longer time, according to a new study. Nearly half the people who took the painkillers for overContinue Reading

Diabetes State Atlas Now Available Online

“CDC’s Division of Diabetes Translation announces the launch of the Diabetes State Atlas (available athttp://www.cdc.gov/diabetes/data), an interactive Internet tool for the public to view maps and charts of diabetes data and trends at the U.S. state level. Some of the features of the atlas include 1) customizable maps and graphics of diabetes surveillance data, 2)Continue Reading

New GAO Reports – Group Purchasing Organizations, Medicare Program Integrity, Defense Logistics, Vaccine Injury Compensation

Group Purchasing Organizations: Funding Structure Has Potential Implications for Medicare Costs, GAO-15-13: Published: Oct 24, 2014. Publicly Released: Nov 24, 2014. Medicare Program Integrity: CMS Pursues Many Practices to Address Prescription Drug Fraud, Waste, and Abuse, GAO-15-66: Published: Oct 24, 2014. Publicly Released: Nov 24, 2014. Defense Logistics: Greater Awareness of Recommendations and Improvements in Data QualityContinue Reading

NFL Concussion Settlement: How Much is a Brain Worth to the NFL?

Video via FRONTLINE: “Thousands of former NFL players are suing the National Football League over brain injuries they got while playing the game. But no brain is the same. So, what is a brain injury worth to the NFL? FRONTLINE explains.”

Global Disease Monitoring and Forecasting with Wikipedia

Global Disease Monitoring and Forecasting with Wikipedia by Nicholas Generous, Geoffrey Fairchild, Alina Deshpande, Sara Y. Del Valle, Reid Priedhorsky. Published: November 13, 2014. “Infectious disease is a leading threat to public health, economic stability, and other key social structures. Efforts to mitigate these impacts depend on accurate and timely monitoring to measure the risk and progress of disease.Continue Reading

New Database of FDA Warning Letters Helps Consumers Avoid Adulterated Products Masquerading as Supplements

“The Council for Responsible Nutrition (CRN), the leading trade association for the dietary supplement and functional food industry, today announced a free online tool that compiles FDA Warning Letters sent to dietary supplement companies into a searchable database to help industry achieve better regulatory compliance. The database can be used to evaluate FDA’s warning letterContinue Reading

New GAO Reports – Compounded Drugs, Bureau of Fiscal Service Audit

COMPOUNDED DRUGS: Payment Practices Vary across Public Programs and Private Insurers, and Medicare Part B Policy Should Be Clarified, GAO-15-85: Published: Oct 10, 2014. Publicly Released: Nov 10, 2014. FINANCIAL AUDIT: Bureau of the Fiscal Service’s Fiscal Years 2014 and 2013 Schedules of Federal Debt, GAO-15-157: Published: Nov 10, 2014. Publicly Released: Nov 10, 2014.

Study Calls Out Workplace Telepressure

Please Respond ASAP: Workplace Telepressure and Employee Recovery. Barber, Larissa K.; Santuzzi, Alecia M. Journal of Occupational Health Psychology, Nov 3 , 2014, No Pagination Specified. http://dx.doi.org/10.1037/a0038278 “Organizations rely heavily on asynchronous message-based technologies (e.g., e-mail) for the purposes of work-related communications. These technologies are primary means of knowledge transfer and building social networks. As a by-product, workersContinue Reading

CFPB Report Finds Debt Collection Tops Older Consumer Complaints

“The Consumer Financial Protection Bureau (CFPB) released a report, A snapshot of debt collection complaints submitted by older consumers, highlighting debt collection as a top complaint for older Americans, many of whom say they struggle with debt in retirement. According to the report, some of the debt collection issues older Americans complain about include collectors: hounding aboutContinue Reading

Medicare Beneficiaries Paid Nearly Half of the Costs for Outpatient Services at Critical Access Hospitals

HHS IG Report (OEI-05-12-00085), October 7, 2014 “The Critical Access Hospital (CAH) certification was created to ensure that rural beneficiaries would have access to hospital services. Medicare reimburses CAHs at 101 percent of their “reasonable costs,” rather than at the predetermined rates set by the Outpatient Prospective Payment System (OPPS). The system that Medicare uses toContinue Reading