CMS Reportedly Withholding More Data from Physician Payment Site

August 29, 2014 in News

The CMS Open Payments System will not include records of research grants that drugmakers make to physicians through intermediaries when the site goes public on Sept. 30, ProPublica reports (Ornstein, ProPublica, 8/28).

Background

The Open Payments System, which is required under the Affordable Care Act’s Sunshine Act, aims to boost transparency by making public what payments health care providers have received from drugmakers and medical device manufactures. CMS said earlier this month that about one-third of CMS Open Payments Systems records will be withheld when the system launches because of data inconsistencies (iHealthBeat, 8/18).

Earlier this month, the American Medical Association and more than 100 other medical professional groups in a letter asked CMS to delay the launch of the database by six months, expressing concern that the database “will not be ready and will likely lead to the release of inaccurate, misleading and false information” (iHealthBeat, 8/15).

Additional Data Withheld

According to ProPublica, a source familiar with the Open Payments System said CMS will withhold data on research grants that drugmakers make because physicians have not had the ability to verify such grant payments, as is required by law.

CMS has not publicly commented about plans to withhold drugmakers’ research grant payments to physicians through intermediaries and has not said how many records would be affected. According to ProPublica, CMS also has not yet answered several other questions about the Open Payments System, including:

  • How consumers searching the Open Payments System will be notified when data are withheld;
  • The number of records reported by companies;
  • The number of total records being withheld;
  • The number of companies that reported incorrect data; and
  • Which submitted data are flawed.

Reaction

Sen. Chuck Grassley (R-Iowa) said, “CMS has had more than four years to figure everything out. It’s disappointing and irresponsible that so many basic questions are unresolved at this late stage.”

Pharmaceutical Research and Manufacturers of America spokesperson Jennifer Wall said that the trade group’s companies “continue to review the data issues surrounding the recent actions by CMS to remove certain information from open payments” but that “they still do not have a full accounting of the rationale behind CMS’ decision and therefore it is difficult for us to fully understand the ongoing data validation issues” (ProPublica, 8/28).

PhRMA Assistant General Counsel John Murphy in a statement said an analysis by the trade group found that its “member companies submitted their data in a manner consistent with the reporting rules outlined by the agency” and requested that CMS release additional guidance “clarifying the reporting regulations” and provide greater transparency around its decision to withhold data (Mixter, Bloomberg BNA, 8/27).

CMS Extends Deadlines for Reviewing, Correcting Data

Meanwhile, CMS on Thursday announced plans to extend the time frame for physicians to review and dispute Open Payments System data and push back the site’s corrections period, Modern Healthcare reports.

CMS said it was making the changes to account for two upcoming “scheduled maintenance upgrades” for the system’s website from 1 a.m. to 11 a.m. on Aug. 30 and on Sept. 5 for a duration that has yet to be disclosed. The agency said that providers will now have until Sept. 10 to review and request corrections to data and that the corrections period will be extended until Sept. 25, with the payment system still set to go public on Sept. 30 (Tahir, Modern Healthcare, 8/28).

AMA in a release said that CMS’ announcement “adds to the growing concerns that the site is simply not ready to go public” and “further underscores the need for physicians to have more time to register, review and correct inaccurate data that may be housed on the government website.” It added, “That’s why the AMA is calling on CMS to extend by six months the time that physicians have to register and ensure the accuracy of their reports before release to the public” (AMA release, 8/28).

Additional Info on Flawed Data Forthcoming

Also on Thursday, CMS said in a notice to physicians said that it would issue further details about the process and timeline for resubmitting flawed data and publicly displaying such data “in the coming weeks.” The agency said it had removed data for which a physician’s medical license number, name and national identification number was not identical to other official data sources.

CMS previously had indicated that it would not release withheld data to the public until June 2015, according to ProPublica (ProPublica, 8/28).

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