Information That May Be Released Upon Authorization by the

160.2 - Information That May Be Released Upon Authorization by the Regional Office (Rev. 1, 09-11-02) The CMS regional office may authorize contractors to release the following information: • Total man-years (or man-quarters, etc.) employed per report period. • Man-hours per claim or bill processed. • Number of weeks' work on hand. • Denial rates. • Percent of claims or total payments involving reduction in charges. Data which contrast one contractor's performance with the performance of any other contractor, or which compare a contractor's performance with any set of national, regional, or other combined contractor performance data, may not be released by the contractor without prior RO approval. The contractor refers requests for such information to the RO. Generally, data of this type will be made available in periodic CMS releases when sufficient to permit valid statistical inferences. When the release of this kind of information is considered valuable for contractor or program public relation, telephone request and approval for contractor release may be appropriate. This section applies only to data compiled in the administration of the health insurance program. The contractor does not need prior RO approval to release, for example, compilations created by the Blue Cross Administration (BCA) or The National Association of Blue Shield Plans (NABSP). Data pertaining to more than one contractor or which compare contractor performance may be released only in proper perspective. Essentially, cost information alone is not an accurate indication of a contractor's performance and, therefore, is not to be publicized without other relevant data accompanying it; e.g., information pertaining to workload volume and processing time. Moreover, release should always be accompanied by an interpretive statement indicating the limitations of the data and the known variables; e.g., wage differentials. Requests which include a provider population beyond the jurisdiction of the contractor may involve data which have not been made available by CMS for public release. Requests for such combined data will be handled by the RO, which, if it approves the release, will furnish the requestor with the appropriate combined data and alert the contractors involved regarding the release.