42 U.S.C. § 1395w–6 — Empowering beneficiary choices through continued access to information on physicians’ services
submitted 11 years ago by Pub. L. 114-10 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 346 words · no verdicts yet
This section requires the Secretary to publish understandable information about physicians and, when appropriate, other eligible professionals who provide items and services to Medicare beneficiaries. It specifies the information that must be included, how the public must be able to search it, and that it must be added to Physician Compare beginning in 2016.
(a) In general. Every year beginning in 2015, the Secretary must make information publicly available in a format that is easy to understand. The information must concern physicians and, when appropriate, other "eligible professionals" who furnish items and services to Medicare beneficiaries under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
(b) Type and manner of information. The information must be similar in type to the information in the Medicare Provider Utilization and Payment Data: Physician and Other Supplier* Public Use File that the Secretary released for 2012. It must also be made available in a way similar to the way the information in that file is made available.
(c) Requirements. At a minimum, the information must include:
(1) Information about the number of services furnished by the physician or other "eligible professional" under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.). This may include information about the services furnished most often or about groups of services.
(2) Information about the charges submitted and the payments for services under that part.
(3) A unique identifier for the physician or other "eligible professional" that is available to the public, such as a national provider identifier.
(d) Searchability. The public must be able to search the information by at least the following:
(1) The physician's or other "eligible professional's" specialty or type.
(2) Characteristics of the services furnished, such as the number of services or groups of services.
(3) The location of the physician or other "eligible professional."
(e) Integration on Physician Compare. Beginning in 2016, the Secretary must add the information made available under this section to Physician Compare.
(f) Definitions. In this section:
(1) Eligible professional; physician; Secretary. The terms "eligible professional," "physician," and "Secretary" have the meanings given to them in section 1395w–5(i) of this title.
(2) Physician Compare. "Physician Compare" means the Physician Compare Internet website of the Centers for Medicare & Medicaid Services, or a successor website.
On an annual basis (beginning with 2015), the Secretary shall make publicly available, in an easily understandable format, information with respect to physicians and, as appropriate, other eligible professionals on items and services furnished to Medicare beneficiaries under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
The information made available under this section shall be similar to the type of information in the Medicare Provider Utilization and Payment Data: Physician and Other Supplier* Public Use File released by the Secretary with respect to 2012 and shall be made available in a manner similar to the manner in which the information in such file is made available.
The information made available under this section shall include, at a minimum, the following:
Information on the number of services furnished by the physician or other eligible professional under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.), which may include information on the most frequent services furnished or groupings of services.
Information on submitted charges and payments for services under such part.
A unique identifier for the physician or other eligible professional that is available to the public, such as a national provider identifier.
The information made available under this section shall be searchable by at least the following:
The specialty or type of the physician or other eligible professional.
Characteristics of the services furnished, such as volume or groupings of services.
The location of the physician or other eligible professional.
Beginning with 2016, the Secretary shall integrate the information made available under this section on Physician Compare.
In this section:
The terms “eligible professional”, “physician”, and “Secretary” have the meaning given such terms in section 1395w–5(i) of this title.
The term “Physician Compare” means the Physician Compare Internet website of the Centers for Medicare & Medicaid Services (or a successor website).
Source credit: (Pub. L. 114–10, title I, § 104, Apr. 16, 2015, 129 Stat. 132.)
- 2015Enacted · Pub. L. 114-10 · 129 Stat. 132
A history note hasn’t been published yet. The record shows enactment by Pub. L. 114-10 on 2015-04-16.
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