December 15, 2006

The Honorable Michael O. Leavitt
Secretary
Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C.  20201

Dear Secretary Leavitt:

The National Committee on Vital and Health Statistics (NCVHS) is charged to advise the Department on health data, statistics and national health information policy.  The Committee also has been called upon by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to develop uniform standards to enable electronic prescribing in ambulatory care.  In these capacities, we would like to express support of the Department’s efforts to make best possible use of Medicare Part D data for research, analysis, reporting and public health, as detailed in the Centers for Medicare and Medicaid Services (CMS) proposed rule (71 FR 61445-55, October 18, 2006).

NCVHS especially commends the attention of the proposed rule to the following public needs:

• the internal requirements of the Medicare program not simply to administer the benefit efficiently, but to track, monitor, and test the use of funds over time to measure their efficacy;
• the potential advancement in public health and scientific programs through the creation of essential research resources;
• the reinforcement of existing national databases from Medicare Parts A and B and the Chronic Condition Warehouse, as well as from the health surveys conducted by other federal agencies and from disease registries such as SEER;
• broad access across agencies through exact record linkage of health and other vital data, which, in turn, can help set the standards for future inter-agency sharing of other, valuable data resources;
• the facilitation of studies and evaluations, both observational and designed—some of which would otherwise be infeasible or unaffordable—to enhance disease surveillance and the identification of rare complications.  

In all or almost all these examples, we believe it to be fairly certain that the opportunities and economies extend well beyond the Medicare program, thus requiring collaboration between CMS and other agencies, as well as private researchers. 

The proposed rule is broadly consistent with NCVHS’ view that public benefits can be enhanced though the sharing of data both across government agencies and with responsible and qualified research organizations.  The proposed rule also recognizes the essential need for appropriate levels of protection of individual beneficiary privacy though the restriction of data releases to the minimum elements necessary for the conduct of the study and subject to the existing mechanisms for data use agreements.   At the individual level, the rule also reflects the increased demand of the public for access to its own records for such purposes as the creation of personal (typically electronic) health records. 

In sum, the NCVHS wishes to reinforce that substantial public benefit can be derived through efforts to make the best use—including sharing of claims information and ancillary data—of information collected under Medicare Part D program.  NCVHS recommends that the Department issue as expeditiously as possible a final rule that is fully supportive of the goals and the mechanisms to pursue them specified in the draft rule.

Sincerely,

/s/

Simon Cohn, M.D., M.P.H.
Chairman, National Committee on Vital and Health Statistics

Cc:       HHS Data Council Co-chairs
            Director, Centers for Medicare and Medicaid Services (CMS)