CMS launching ACO database with identifiable participant info

The Centers for Medicare & Medicaid Services (CMS) will launch a new accountable care organization (ACO) records database that will house personally identifiable information about participants in the Shared Savings Program and Pioneer ACO Program, according to a CMS announcement. The information will include Medicare beneficiaries, healthcare sole proprietors, ACO leaders and managers, and other ACO-related persons and span data, such as names, gender, Social Security numbers, birthdays, addresses, health insurance claim numbers, and types of services, among other information. To participate in the voluntary Shared Savings Program, ACO participants must "provide the Secretary with such information regarding the ACO professionals participating in the ACO as the Secretary determines necessary to support the assignment of Medicare fee-for-services beneficiaries to an ACO, the implementation of quality and other reporting requirements ... and the determination of payments for shared savings," according to the announcement.

Under the law, an agency can disclose information about an individual without his or her content if the information is used for the purpose for which the information was collected, meaning, the Department of Health & Human Services (HHS) and CMS can only release personally identifiable information for routine use. In addition, relevant HHS and CMS contractors, grantees, and consultants will have access to the records on a need-to-know basis, according to the announcement.