‘Open Payments’ moves forward despite snags

Washington-Physicians, including urologists, now have another headache to deal with-making certain information about them published on the Internet by the federal government is accurate and not misleading to patients who want to know about the financial benefits their doctors receive from manufacturers of drugs, devices, and biologic and medical supplies.

Related - Report questions doc shortage; AUA concerned

It’s all part of the National Physician Payment Transparency Program (Open Payments) established by the Affordable Care Act (ACA), which requires manufacturers to collect data on payments or items of value given to teaching hospitals and physicians. Manufacturers must also report certain ownership or investment interests by physicians or their immediate family members held at any point during the reporting year.

The website containing the data reported by manufacturers was slated to go live on Sept. 30, when the Centers for Medicare & Medicaid Services would make public details about provider payments made from Aug. 1, 2013 to Dec. 31, 2013. Physicians and teaching hospitals had until Sept. 8 to sign up, review their records, and dispute any discrepancy.

Tech issues hamper program

The Open Payments program has been plagued with delays and technical snafus. CMS took the system offline Aug. 3 to resolve a technical issue, and it was not restored until Aug. 15. According to CMS, an investigation into a physician complaint found that manufacturers and group purchasing organizations (GPOs) submitted intermingled data, such as the wrong state license number or national provider identifier for physicians with the same last and first names.

On Aug. 15, CMS said it has resolved the issue and revalidated all data to make sure physician identifiers used by the applicable manufacturer or GPOs are accurate. Incorrect payment transactions were removed and will not be published, CMS added.

“We have identified the root cause of the problem and have instituted a system fix to prevent similar errors. We strongly encourage physicians to review their records before the deadline and before the data are posted publicly to identify any discrepancies,” said Shantanu Agrawal, MD, CMS deputy administrator and director of the Center for Program Integrity.

Going forward, the ACA requires manufacturers to report the information annually to CMS by June 30 of each year. So physicians who want to make sure the data about them is accurate must be vigilant and check it within CMS guidelines.

According to CMS, physicians are not required to register with or send any information to Open Payments. However, to make sure CMS has correct information, physicians are encouraged to keep records of all payments and other transfers of value received from manufacturers or GPOs, register with the program, subscribe to its listserv, look at the applicable information, and work with manufacturers and GPOs to make sure the information submitted about them is correct. 

Next: AUA, LUGPA send letter to CMS administrator

More "Washington and You" articles from Bob Gatty

Proposed EHR rule offers ‘breathing room’

Expect federal scrutiny of RUC to intensify

SGR patch includes ‘troubling’ provision

A group of more than 100 national and state medical organizations, including the AUA and the Large Urology Group Practice Association (LUGPA), sent a letter Aug. 5 to CMS Administrator Marilyn Tavenner urging that information collected so far not be made public until March 31, 2015. They said the extra time was needed because the opportunity for physicians to register had been delayed for 6 months after the original Jan. 1 target date.

“The agency has not provided effective notification to the vast majority of physicians nor provided a reasonable amount of time for the undersigned organizations to engage and educate physicians on the registration and dispute process,” the letter declared. “Early in the regulatory process, medicine informed CMS that a minimum of 6 months would be needed to ensure an adequate amount of time for outreach on registration and the dispute process.”

In addition, the medical groups noted that “many physicians are expressing frustration at an overly complex registration process which, combined with the condensed time frame, makes the task of reviewing and disputing reports by Aug. 27 effectively impossible for the agency’s estimated 224,000 covered physician recipients.”

A similar letter was sent to Tavenner July 28 by the Alliance of Specialty Medicine, of which the AUA is a member.

AUA: Industry-doc relationships ‘integral’

Meanwhile, in an online fact sheet regarding the program, the AUA notes that the reports “will provide increased transparency about financial relationships between biopharmaceutical companies, device manufacturers, and health care providers. The AUA also points out that the collaboration between physicians and biopharmaceutical companies in research is “integral” in finding breakthrough treatments for patients.

The AUA adds that manufacturers play a key role in sharing accurate, up-to-date information on new drugs and technologies with physicians, which helps them stay current on the newest treatments available.

“The AUA supports the principles of the Physician Payments Sunshine Act and transparency between physicians and industry,” the fact sheet states. “We are committed to providing meaningful background about ways in which physicians and the biopharmaceutical industry collaborate for patients.”

The AUA adds that “when shared within the appropriate context,” the data provided by the program can help patients learn more about industry-physician collaborations and understand how these interactions benefit them, and notes that those companies compensate physicians “reasonably” for their expert contributions and time devoted to clinical research and to helping educate peers about new medicines and innovations.UT 

Subscribe to Urology Times to get monthly news from the leading news source for urologists.