Skip to content Skip to navigation

CMS Expands Access to Claims Data

June 3, 2015
by Gabriel Perna
| Reprints
The Centers for Medicare and Medicaid Services (CMS) is opening up its claims data for private entrepreneurs and researchers to use more frequently, the agency announced this week at Health Datapalooza.
The new policy will allow entities to submit research requests to use the data to improve the healthcare system. The researchers will be allowed to make the requests on a quarterly basis. Traditionally, any claims data available from CMS has only been available on an annual basis.
Once their requests are approved, the innovators will have access in CMS' new Virtual Research Data Center (VRDC). The VRDC will include granular CMS program data, such as Medicare fee-for-service claims data. Researchers working in the VRDC will have direct access to approved privacy-protected data files, which does not include patient identity. However, it will include the provider's identity.
CMS notes that researchers also will not be allowed to remove patient-level data from the VRDC. They will only be able to download aggregated, privacy-protected reports and results to their own personal workstation.
“Historically, CMS has prohibited researchers from accessing detailed CMS data if they intended to use it to develop products or tools to sell,” Niall Brennan, CMS chief data officer and director of the Office of Enterprise and Data Analytics, said at Health Datapalooza. “However, as the delivery system transforms from rewarding volume to value, data will play a key role. We hope that this new policy will lead to additional innovation and insights from the CMS data.”
The announcement is part of CMS' open data movement. Earlier this week at Health Datapalooza, it published its physician and supplier utilization and payment data for the second straight year. 


ONC National Coordinator Gets Live Look at Carequality Data Exchange

Officials from Carequality have stated that there are now more than 150,000 clinicians across 11,000 clinics and 500 hospitals live on its network. These participants are also able to share health data records with one another, regardless of technology vendor.

American Red Cross, Teladoc to Provide Telehealth Services to Disaster Victims

The American Red Cross announced a partnership with Teladoc to deliver remote medical care to communities in the United States that are significantly affected by disasters.

Report: The Business of Cybercrime in Healthcare is Growing

While stolen financial data still has a higher market value than stolen medical records, as financial data can be monetized faster, there are indications that there is ongoing development of a market for stolen medical data, according to an Intel Security McAfee Labs report.

Phishing Attack at Baystate Health Potentially Exposes Data of 13K Patients

A phishing scam at Baystate Health in Springfield, Mass. has potentially exposed the personal data of 13,000 patients, according to a privacy statement from the patient care organization and a report from MassLive.

New Use Cases Driving Growth in Health Data Exchange through Direct

In an update, DirectTrust reported significant growth in Direct exchange of health information and the number of trusted Direct addressed enabled to share personal health information (PHI) in the third quarter of 2016.

Insurers to CBO: Consider Private Insurers’ Data in Evaluations of Telemedicine

Eleven private insurers, including Aetna, Humana and Anthem, are urging the Congressional Budget Office (CBO) to consider the experience of commercial insurers when evaluating the impact of telemedicine coverage in Medicare.