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CMS Announces First “Qualified Entities” To Receive Medicare Data under Affordable Care Act Program

Stuart M. Langbein

Stuart M. Langbein,

Washington, D.C.

Emily Gebbia

27 November 2012
As part of the Patient Protection and Affordable Care Act, Congress created a new program making certain Medicare data available to “qualified entities” for the “the evaluation of the performance of providers of services and suppliers.”  On December 7, 2011, CMS published a final rule implementing the data use program, which it refers to as the Qualified Entity Program (QEP).  In the final rule, CMS elaborates on the requirements for an entity to be “qualified” as well how the data may be used by qualified entities.  Last week, CMS announced the first three qualified entities that are eligible to receive data under the QEP.  They are the Health Improvement Collaborative of Greater Cincinnati, the Kansas City Quality Improvement Consortium, and the Oregon Health Care Quality Corporation. 

Given that CMS indicated that it would provide data under the QEP to every entity that met the regulatory criteria, the fact that it has identified only three quality entities suggests that the agency is strictly interpreting its own guidance.  It also is worth noting that CMS had estimated in the final rule that 25 organizations would be approved to participate in the QEP as qualified entities.  Although the application process is a rolling one, the fact that CMS has only approved three applications so far suggests that the program may not have a very significant effect on the dissemination of Medicare data.

Stuart M. Langbein

Stuart M. Langbein,

Washington, D.C.

Emily Gebbia

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