All provider claims for risk adjusted Medicare advantage are currently 
submitted to CMS's RAPS system, but it only requires 5 fields.  Soon they will 
be getting full 837 claims via the new EDPS system.

It's very common to run analytics on this data for purposes of finding under 
treated patients.  You can even power campaigns by using the lack of data.  For 
example, no physical therapy claim after knee surgery, or no vasodilator if the 
patient is HCC 16 (diabetes w vascular complications), or even simply no PCP 
visit this year.

In other words, seems like the government already has this data, however given 
their historical expertise in manipulating it I wouldn't be too worried.

That said I didn't read the link :)



On Sep 23, 2011, at 10:00 PM, Robert Munn <[email protected]> wrote:

> 
> cool, thanks!
> 
> On Fri, Sep 23, 2011 at 7:49 PM, Judah McAuley <[email protected]> wrote:
> 
>> 
>> I don't think this is accurate. I glanced at the rule when it was
>> proposed and there hasn't been any uproar in the medical world that
>> I've seen, so I'm dubious. But I don't know for certain. I'll do some
>> investigation and try to reply back here in a couple days.
>> 
>> Judah
>> 
> 
> 
> 

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