Survey: Physician Payment Reporting Requirements Spark Confusion

June 9, 2014 in News

Drugmakers have raised several concerns about reporting requirements under the Affordable Care Act’s Physician Payment Sunshine Act, according to a new survey, the Wall Street Journal‘s “Pharmalot” reports (Silverman, “Pharmalot,” Wall Street Journal, 6/5).

Background

In February, CMS released a long-awaited final rule on the Physician Payment Sunshine Act — also known as the OPEN PAYMENTS system — and outlined a timeline for its implementation.

The Sunshine Act requires medical industry companies to disclose consulting fees, travel reimbursements, research grants and other gifts that they give to physicians and teaching hospitals.

As of Aug. 1, 2013, manufacturers of pharmaceutical and biological drugs, medical devices and medical supplies are required to report all transfers of monetary value over $10 to physicians and teaching hospitals.

All data collected from August through December was due to CMS by March 31, 2014, according to the final rule. The agency will publish the data on a public website by Sept. 30, 2014 (iHealthBeat, 7/30/13).

Survey Details, Findings

For the survey, Polaris — a pharmaceutical consultant group — polled 35 regulatory officers and attorneys after the first phase of the reporting process, which required drugmakers to report lump sum payments made to physicians between Aug. 1, 2013, and Dec. 31, 2013.

The survey found:

  • Nearly 47% of respondents said they believe the data they report to CMS will contain significant to moderate discrepancies;
  • Nearly 44% of respondents reported at least one physician payment that raised compliance concerns or required a “significant” follow up;
  • Drugmakers dedicated just 28% of their time to verifying reported data; and
  • 6% of respondents failed to validate their data.

In addition, the survey showed 32% of drugmakers were not certain about what information to report. For example:

  • 23% were unclear about properly identifying teaching hospitals;
  • Nearly 20% were confused about reporting requirements for physician meals at continuing education programs; and
  • Nearly 7% were unsure about the value of medical journal reprints that were distributed to physicians.

Alice Dong, a senior consultant at Polaris, said physicians have raised concerns about data verification and interpretation. She said, “There’s a lot of concern in the physician community about the way the information is reported and interpreted, and they are concerned it can be skewed” (“Pharmalot,” Wall Street Journal, 6/5).

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