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《信息自由法》与医疗保险费用报告。

The Freedom of Information Act and Medicare costs reports.

作者信息

Shulman L J

出版信息

Am J Law Med. 1981 Winter;6(4):543-58.

PMID:7032285
Abstract

Health care providers must submit cost reports to the Department of Health and Human Services or its designated intermediary before they can be reimbursed for their services by the Medicare system. These reports closely detail the financial operations of the provider. Whenever third parties have requested copies of the cost reports pursuant to the Freedom of Information Act and the Department of Health, Education and Welfare (now HHS) has declared its intention to comply with the request, the providers have sued to enjoin disclosure. This Note evaluates whether the cost reports are confidential and therefore exempt from mandatory disclosure under Exemption 4 of the Freedom of Information Act. It concludes that they should not be exempt, but that even if they are, disclosure is mandated by a validly promulgated HEW regulation. This regulation was enacted in compliance with the Administrative Procedure Act, and should not be considered on abuse of the HEW Secretary's discretion.

摘要

医疗服务提供者必须向卫生与公众服务部或其指定的中介机构提交成本报告,之后才能通过医疗保险系统获得服务报销。这些报告详细说明了提供者的财务运作情况。每当第三方根据《信息自由法》要求获取成本报告副本,且卫生、教育与福利部(现为卫生与公众服务部)表示打算遵守该请求时,提供者就会提起诉讼以禁止披露。本注释评估成本报告是否属于机密信息,因此根据《信息自由法》第4条豁免规定可免于强制披露。结论是它们不应被豁免,但即便它们属于豁免范围,根据卫生、教育与福利部有效颁布的一项法规,仍需进行披露。该法规是依据《行政程序法》制定的,不应被视为卫生、教育与福利部部长滥用自由裁量权。

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