[Congressional Record Volume 159, Number 87 (Tuesday, June 18, 2013)]
[Senate]
[Page S4589]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRASSLEY (for himself, Mr. Wyden, and Mr. Bennet):
  S. 1180. A bill to amend title XI of the Social Security Act to 
provide for the public availability of Medicare claims data; to the 
Committee on Finance.
  Mr. GRASSLEY. Mr. President, today, Senator Wyden and I reintroduced 
the Medicare Data Access for Transparency and Accountability Act. This 
collaborative effort includes two ideas for making Medicare billing and 
spending more transparent.
  The first provision comes from a bill I introduced in 2011 to enhance 
the government's ability to combat Medicare and Medicaid fraud. It 
would require the Secretary of Health and Human Services to issue 
regulations making Medicare claims and payment data available to the 
public, similar to other federal spending disclosed on 
www.USAspending.gov.
  That website was created by legislation sponsored by then-Senator 
Obama and Senator Coburn. It lists almost all federal spending, but it 
doesn't include payments made to Medicare providers.
  That means virtually every other government program, including some 
defense spending, is more transparent than the Medicare program.
  Omitting Medicare spending is especially alarming when you consider 
the portion of Federal spending that goes through the Medicare program. 
In 2011, the Federal Government spent $549 billion on Medicare.
  Taxpayers have a right to see how their hard-earned dollars are being 
spent. There should not be a special exception for hard-earned dollars 
that happen to be spent through Medicare.
  Transparency will restore that taxpayers' right.
  Also, if doctors know that each claim they make will be publicly 
available, it might deter some wasteful practices and overbilling.
  Our bill accomplishes this by requiring the Secretary of Health and 
Human Services to make available a searchable Medicare payment database 
that the public can access at no cost.
  The second provision in our bill clarifies that data on Medicare 
payments to physicians and suppliers do not fall under a Freedom of 
Information Act, FOIA, exemption.
  In 1979, a U.S. District Court ruled that Medicare is prohibited from 
releasing physicians' billing information to the public.
  For over three decades, third parties that tried to obtain physician 
specific data through the FOIA process have failed. Taxpayers have been 
denied their right.
  Another recent court decision lifted the injunction, but it does not 
go far enough.
  Our bill would make Congress' intent clear and provide the public 
with the tools to finally gain access to important Medicare data.
  I would like to provide one example of how valuable access to 
Medicare billing data can be.
  In 2011, using only a small portion of Medicare claims data, the Wall 
Street Journal was able to identify suspicious billing patterns and 
potential abuses of the Medicare program.
  The Wall Street Journal found cases where Medicare paid millions to a 
physician sometimes for several years, before those questionable 
payments stopped.
  That was only one organization using a limited set of Medicare data. 
When it comes to public programs like Medicare, the Federal Government 
needs all the help it can get to identify and combat fraud, waste and 
abuse, and that is why a searchable Medicare claims database should be 
made available to the public.
  I have often quoted Justice Brandeis, who said, ``Sunlight is the 
best disinfectant.'' That is what Senator Wyden and I are aiming to 
accomplish with the Medicare Data Act.
  Mr. WYDEN. Mr. President, I rise today with Senator Grassley to 
introduce the Medicare Data Access for Transparency and Accountability 
Act. I would like to begin by thanking my friend and esteemed colleague 
for his unwavering commitment to greater transparency and 
accountability in government. This Medicare DATA Act advances that 
goal.
  Sunshine continues to be the greatest disinfectant. In that light, 
the Medicare DATA Act ensures all taxpayers have access to Medicare 
Claims Database, both to aid them in making medical decisions, and in 
understanding what their money is paying for in this vital, yet 
enormous, health program. The Medicare Claims Database is an important 
resource for public and private stakeholders as it captures healthcare 
provider payment and claims information for roughly one-third of the 
United States healthcare system. But why isn't this information already 
available?
  In 1978, the Department of Health Education and Welfare attempted to 
release this information, upon request, under the premise that 
accessibility to the source data was in the public interest and 
therefore should be made available for public consumption. An 
injunction by a Florida court, however, ordered otherwise.
  I am pleased that the Florida court has reevaluated that decision and 
recently lifted the injunction. This is a step in the right direction, 
but the decision still leaves access to this data ``opaque.'' Data 
requests are still subject to the Freedom of Information Act and can be 
denied by Health and Human Services. Passage of the Medicare DATA Act 
would put an end to that loophole.
  Information affecting the American taxpayer should be part of the 
public domain in a free society. With this principle in mind, I join 
with Senator Grassley in changing ``business as usual.''
  I urge my colleagues to support this legislation so that Medicare 
data is finally fully transparent and available to Medicare 
beneficiaries and taxpayers alike. I look forward to working with my 
colleagues in this effort.
                                 ______