CMS Proposes Expanded Use of Part D Data – Will it Stay Confidential?

April 3, 2007

On October 18, 2006, the Center for Medicare & Medicaid Services (CMS) issued a proposed rule expanding the collection and permitted uses of Part D data. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) permits, and in some cases requires, CMS to use Part D data for purposes other than to determine proper subsidy and reinsurance payments to Part D plans. However, CMS acknowledges that Section 1860D-15 of the Social Security Act restricts the use and dissemination of Part D data to employees, officers and contractors of the United States Department of Health and Human Services (HHS) for making payments to Part D plans. By contrast, Section 1860D-12(b)(3)(D) allows data collection for purposes the HHS Secretary (as delegated to CMS) deems necessary and appropriate. The proposed rule is intended to resolve the apparent statutory ambiguity and provide an opportunity for public comment on the proposed expanded uses of Part D data.