AOTA Federal Policy is a blog maintained by AOTA’s Federal and Regulatory Affairs Departments, covering the latest happenings in Congress, the White House, and across the federal agencies. While the battles of Washington often seem far removed from your role as a practitioner, student, educator, or business owner, public policy undoubtedly shapes the way you practice, what you are paid, and who you’re able to see. We hope this blog serves as a means to bring you closer to the process and keep you up to date on the latest federal issues affecting your practice.
In addition to the content on this blog, you can still find regular updates and information on our Congressional Affairs and Regulatory Affairs pages by visiting AOTA’s website including our Legislative Action Center.
This Tuesday, the Centers for Medicare and Medicaid Services (CMS) released for the first time information that details how much individual providers billed, how much they were paid, and what treatment was provided. Included is data from 2012 that covers $77 billion in payments to 880,000 different providers for Medicare Part B. Providers with fewer than 11 Medicare patients and individual patient information are not disclosed.
You can search the database here.
In total 43% of Medicare payments went towards office overhead, 41% towards provider compensation, 13% for drugs and other costs, and 3% towards malpractice premiums. This information has not been publicly available since 1979, but due to a court ruling last year, CMS was able to release this data.
This is a clear move towards transparency for Medicare Part B. While OT’s are included in the data, they are not a specialty that is in the top 2% of billing, which has so far invited harsher scrutiny. That top 2% accounted for nearly 25% of all Part B payments. The most notable information gathered from the data so far is that only a small percentage of Medicare providers receive a very large share of Medicare dollars, and federal agencies and consumer groups will be using the recently-released data to identify improper variation and target bad actors.
AOTA will continue to analyze this data and monitor any developments resulting from the increased transparency.