Industry Groups, Providers Comment on Physician Payment Website

October 1, 2014 in News

Reaction to the launch of CMS’ online Open Payments System has been mixed, with some doctors and industry groups raising concerns about usability and data errors and others commending the increased transparency, Politico reports (Wheaton, Politico, 9/30).

Background

Yesterday, CMS launched its Open Payments System, which is required under the Affordable Care Act’s Sunshine Act and aims to boost transparency by making public what payments health care providers have received from drugmakers and medical device manufactures (iHealthBeat, 9/30). 

In addition, to medical doctors, the disclosure rules under the Sunshine Act apply to chiropractors, dentists, podiatrists and optometrists (Thomas et al., “Business Day,” New York Times, 9/30).

Physicians whose data are listed in the online database had until Sept. 25 to review and dispute payments, though many providers reported issues registering and accessing the data (iHealthBeat, 8/29).

CMS officials say just 26,000 of the 546,000 health care professionals, and 400 of the 1,360 teaching hospitals listed in the database registered to verify their data before they were released (Politico, 9/30).

Database Details

Overall, the data show manufacturers made 4.4 million payments to physicians and teaching hospitals during the time frame valued at $3.5 billion.

The database divides the records into three categories:

  • General payments;
  • Research payments; and
  • Physician ownership and investments.

The first round of data includes payments made between Aug. 1, 2013, and Dec. 31, 2013 (iHealthBeat, 9/30).

However, the data are incomplete, with 40% of payments lacking the names of doctors or hospitals that received the payments (Politico, 9/30).

Last month, CMS said that about one-third of Open Payments Systems records would be withheld when the system launched because of data inconsistencies (iHealthBeat, 9/30). 

CMS says it will re-release the data with the correct names by next June.

Specifically, the data show pharmaceutical and medical device companies’ payments to health care providers during the last five months of 2013 totaled:

  • $302.5 million for royalty and licensing;
  • $202.6 million for promotional speaking;
  • $158.2 million for consulting fees;
  • $92.8 million for food and beverages;
  • $74.1 million for travel and lodging; and
  • $19.2 million for gifts.

Of the recorded payments, the data show:

  • 69% of the value of general payments went to medical doctors;
  • Nearly 25% went to teaching hospitals; and
  • Less than $83,000 went to chiropractors (Ornstein, ProPublica, 9/30).

Data Errors, Technical Issues, Delays

Meanwhile, some doctors are reporting errors in the publicly released data.

For example, Reisa Sperling, a neurologist at Harvard Medical School, said she received up to $5,000 from pharmaceutical company Boehringer Ingelheim for a one-day consulting assignment, but the data show she was paid more than $155,000 for travel expenses in September 2013. A spokesperson from Boehringer Ingelheim also confirmed that the amount was incorrect and that the company had previously alerted the government to the error (“Business Day,” New York Times, 9/30).

According to ProPublica, some users experienced long delays and error messages as they tried to access the website’s data. In addition, the website does not contain a user-friendly search tool to look up providers by name and view results contained in various data files (ProPublica, 9/30). Instead, users who wish to look up an individual provider must go to the homepage to access a separate page, open a database and manually scroll through various data fields to view basic payment information (“Business Day,” New York Times, 9/30).

Some Groups Criticize Data Release

In a release, the American Medical Association said that while it supports the Sunshine Act, it is concerned about the quality of data released and the potential for consumers to be misled by the data. Specifically, AMA criticized CMS’ short review period and complex registration process, noting that just 26,000 of the 550,000 physicians affected were able to point out inaccurate information and seek corrections.

AMA added that “publishing inaccurate data leads to misinterpretations, harms reputations and undermines the trust that patients have in their physicians” (AMA release, 9/30).

Similarly, Biotechnology Industry Organization President and CEO Jim Greenwood in a statement criticized that data’s lack of context. He said it is “disappointing that CMS failed to provide the necessary context about these disclosures — and how they should be read” because “some third parties” could “attempt to misuse the data.”

As a result, health care innovation could be hindered, he said. He added that BIO will work with CMS to quickly provide context (BIO release, 9/30).

Meanwhile, a group of academics from Johns Hopkins University in an article published in the Annals of Internal Medicine argued that a provision under the law that requires drugmakers to report “research payments” made to researchers for clinical trials does not accurately portray how much money an individual receives, the Wall Street Journal‘s “Pharmalot” reports.

Specifically, they noted that the reports do not set a value assigned to medicines provided for research. In addition, donated drugs are listed as being given to individual researchers rather than the university where the trial is taking place.

They wrote, “Donated drugs are intended for use by patients and do not provide direct monetary value to physician-investigators. The Physician Payment Sunshine Act rules cloud this critical distinction” (Silverman, “Pharmalot,” Wall Street Journal, 9/30).

AARP, Grassley Commend Data Release

Debra Whitman — AARP’s executive vice president of policy, strategy and international affairs and Leigh Purvis — director of health services researcher in AARP’s Public Policy Institute — in a Roll Call opinion piece wrote that AARP believes the increased transparency provided by the payment database will bolster accountability of health care providers.

In addition, Whitman and Purvis said that “[w]hile not all relationships between health care providers” and drugmakers and medical device manufacturers “are problematic,” the Sunshine Act will “help ensure that provider-industry relationships finally receive appropriate scrutiny” (Whitman/Purvis, Roll Call, 9/30).

In a De Moines Register opinion piece, Sen. Chuck Grassley (R-Iowa), co-author of the Sunshine Payment Act, wrote that from its implementation, the Open Payments System “will be helpful in shining light on a part of medicine most people haven’t had the time or opportunity to consider.”

He noted that the system’s success relies on accurate data and physicians “taking the opportunity to confirm the accuracy of payments reported with their names.” In addition, he said since the initial database will not include some physician’s names, that and other “shortcomings will need to improve considerable in the future” (Grassley, De Moines Register, 9/30).

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