Is Sunlight the Best Disinfectant?

Earlier today, CMS released data revealing financial ties between physicians and other sectors of the healthcare industry.  This August—December 2013 data is now available to the public on CMS’ website and includes 4.4 million transactions amounting to $3.5 billion in payments, involving 546,000 doctors and 1,360 teaching hospitals.  The payments disclosed on the website include:  consulting fees, speaking fees, research payments, gifts, meals, entertainment, travel, educational items, royalties, honoraria, and charitable contributions.

The release of this data was mandated by the Physician Payment Sunshine Act, part of the Patient Protection and Affordable Care Act, which aims to improve transparency of financial relationships and expose conflicts of interest between physicians and the health care industry.  Rules were promulgated requiring manufacturers to disclose certain payments and items of value given to physicians and teaching hospitals.

Starting August 1, 2013, drug and device manufacturers have been required to track all of the following: any “transfer of value” of $10 or more to physicians; transfers of value under $10 that add up to more than $100 a year; and physicians’ ownership stakes in drug and device companies.  Once reported to CMS, physicians have the opportunity to review and challenge these disclosures.

Industry and physician groups have criticized this first data release, stating that it raises more questions than answers.  Before the data was released, life science trade associations sent a letter to CMS Administrator Marilyn Tavenner expressing concern that the data will be misleading since the public will not understand the context of payments.   In August, the American Medical Association requested a delay in the release, stating that physicians were not provided adequate time to confirm the accuracy of the reported payments.  CMS ultimately decided to withhold about one-third of reported payments due to suspected inaccuracies.

The press has also been critical of CMS’ data.  Although the goal of the release is increased transparency, the website is not user-friendly.  The Wall Street Journal summarizes the problems: there is no search box; there are multiple databases; there are no bottom-line numbers; the chart has numerous columns, making it difficult to peruse.  In spite of these shortcomings, various news outlets and organizations, including Policy & Medicine, have analyzed and aggregated the data for the public.

The next release of data covering the 2014 calendar year will occur in the summer of 2015.  In the meantime, we will be watching to see if this new transparency leads to any changes in the relationships between physicians and drug and device manufacturers.

Varsha Gadani

Varsha Gadani

Varsha Gadani focuses her practice on the health care industry. Her clients include hospitals, physicians, behavioral health care providers, long-term care facilities, and other providers. Prior to joining Parker Poe, Ms. Gadani served as Assistant Counsel at the North Carolina Medical Society (NCMS). In this role, she performed a variety of legal functions for the NCMS. She monitored and analyzed emerging state and federal health law issues and advised physicians on health policy matters.

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