Department of Health, Education & Welfare, 479 F. The government also pointed out it could not release physician-identifying data because it had been perma nently enjoined in Florida Medical Ass'n v. Because the reques ted information-the physician-identifying data in par ticular-would reveal individual physicians' annual in comes from Medicare, the government objected to the release of the requested data as a "clearly unwarranted invasion of personal privacy," making the information exempt from disclosure under FOIA Exemption 6. Using the information petitioner requested and the fee schedules CMS publishes, a person could determine an individual physician's annual income from Medicare reimbursement. Petitioner's request seeks, as described above, the diagnosis, the type and place of service, and the UPIN of the physician who performed the service. 10, 2010) (listing petitioner's re gions of coverage as, inter alia, Chicago Area, Puget Sound Area, and Washington D.C. 552, seeking certain data from Medicare claims records submitted by physicians in Illinois, Washington, the District of Colum bia, Maryland, and Virginia during 2004.
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Petitioner brought this action under the Free dom of Information Act (FOIA), 5 U.S.C. Petitioner is a "nonprofit consumer information and service resource" that offers, inter alia, a "guide to top doctors." See Consumers' Checkbook, (last visited Mar. As relevant here, CMS has "data elements include the diagnosis, the type and place of service and the Unique Physician Identifying Number (UPIN) of the physician who performed the services." Pet. Incident to enrolling providers and suppliers, and to making payments for health services rendered to benefi ciaries, CMS maintains certain information about Medi care providers and suppliers, the diagnoses they have made, and the procedures they have performed for which they have claimed Medicare reimbursement. Based on a variety of factors, CMS determines and publishes fee schedules detailing the amounts it will pay any provider or supplier in a given area to perform various procedures. 1395k, 1395l (entitlement to and payment of benefits). 1395a(a) ("Any individual entitled to insurance benefits under may obtain health services from any * * * person qualified to participate under this sub chapter.") 42 U.S.C. 424.510 (pro vider and supplier enrollment procedures) 42 U.S.C. 424.505 (provider and sup plier enrollment requirement) 42 C.F.R.
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Medicare benefi ciaries choose to obtain health services from those pro viders and suppliers (including physicians), and CMS makes payments to those providers and suppliers for those services. Rather, CMS is responsible for enrolling health care providers and suppliers in Medicare. As the court of appeals recognized, "hile CMS has certain responsibilities to promote quality healthcare for Medi care beneficiaries, it is not authorized to 'exercise any supervision or control over the practice of medicine or the manner in which medical services are provided.'" Pet.
Centers for Medicare & Medicaid Services (CMS), What Is Medicare?, Apr.
"Medicare is health insurance for people age 65 or older" or who have certain disabilities or health con ditions. The jurisdiction of this Court is in voked under 28 U.S.C. On August 13, 2009, the Chief Justice extended the time within which to file a petition for a writ of certiorari to and including October 30, 2009, and the petition was filed on that date. A petition for re hearing was denied on J(Pet. The judgment of the court of appeals was entered on Janu(Pet. The opinion of the court of appeals (Pet. 552(b)(6), because those particular records would, as a factual matter, reveal the physicians' per sonal income but would not be useful in assessing the administration of Medicare.ĭEPARTMENT OF HEALTH AND HUMAN SERVICES, ET AL. 552, as a "clearly unwarranted invasion of personal privacy," 5 U.S.C. Whether the court of appeals correctly determined that certain records of Medicare reimbursements to par ticular physicians were exempt from disclosure under the Freedom of Information Act, 5 U.S.C.
In the Supreme Court of the United StatesĭEPARTMENT OF HEALTH & HUMAN SERVICES, ET AL.
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